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K. Rohrschneider, C. Springer, S. Bültmann; Kinetic Perimetry - Fundus Controlled versus Conventional Examination. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5211. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Fundus perimetry with the scanning laser ophthalmoscope (SLO) has been established for determination of functional defects in the diagnosis of macular diseases. Generally, static test strategies are limited in the delineation of small scotomas. Purpose of this study was to evaluate the value of kinetic fundus perimetry in comparison to conventional kinetic perimetry (Goldmann) and scotoma detection with Amsler-charts.
The results of 245 kinetic fundus perimetries in patients with different macular diseases (e.g. age-related macular degeneration, Stargardt’s disease, macular holes, macular scars) were compared with Goldmann visual fields or Amsler-charts. Either a manual or an automated kinetic test strategy was used with the SLO. Perimetric results were compared towards delineation, size and location of the scotomata.
Especially for the detection and delineation of circumscribed central retinal pathologies such as macular holes or neovascular membranes kinetic perimetry with the SLO under simultaneous control of fundus and fixation proved to be superior to all conventional methods. Small central or pericentral scotomas could not be detected at all in 17% of the cases and differed by more than 5 degrees in size with conventional Goldmann perimetry in comparison to kinetic fundus perimetry. Using Amsler charts we found good concordance of pathology, while 25 patients with metamorphopsia showed only small relative scotomas during fundus perimetry. Dislocation of the scotoma caused by extrafoveal fixation was only detectable by fundus-controlled examination.
In the area of fundus-controlled examinations with the SLO, kinetic perimetry allows an exact detection of scotomas within short examination time. In comparison to static threshold perimetry outlining of scotomas proved to be more precise and much faster. An automated stimulus projection reduces the influence of the examiner by standardizing the projection velocity. Kinetic fundus perimetry represents especially for instable or extrafoveal fixation a valuable device for correlation of morphologic and functional findings, particularly for small scotomas, and is superior to conventional methods.
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