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N.K. Pang, J.J. Woog, E.A. Bradley; Comparison of Automated and Manual Perimetry in Patients With Blepharoptosis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4322.
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Purpose: To compare the effectiveness and efficiency of automated versus manual perimetry in patients with blepharoptosis. Although both automated and manual perimetry are capable of detecting field loss associated with blepharoptosis, the most efficient method of testing is uncertain. Riemann et al1 found no difference between the two techniques in the ability to detect visual field (VF) loss in 12 patients. They did report significantly longer testing times with the Humphrey Field Analyzer I 640 (HFA) (mean ± SD, 50 ± 10 minutes) than with Goldmann perimetry (10 ± 2 minutes). Our clinical experience, however, suggests that automated perimetry may be more efficient than reported. Additionally, the Riemann study was performed with an earlier version of HFA software than is currently available. Finally, the preference of blepharoptosis patients for one testing modality over another has not been evaluated. Methods: Both eyes of 20 adult blepharoptosis patients (10 male, 10 female) were prospectively examined using the Humphrey Field Analyzer II 750i and Goldmann perimetry with the eyelids ptotic and taped into a normal position. The order of VF testing was randomly assigned and VF technicians were masked to the test results. Parameters recorded include VF results, test time, and a questionnaire to evaluate patient preference. The t–test for paired data was used for data analysis. Results: Bilateral mean examination time was 12.1 ± 2.9 minutes for Goldmann fields and 18.5 ± 3.8 minutes for Humphrey fields (p<0.001). Superior field loss at the 90° meridian was 23.3° ± 6.7° for Goldmann perimetry and 26.8° ± 13.6° for Humphrey perimetry (p=0.29). The ability to detect >12° superior field loss at the 90° meridian was 95% (19/20 patients) for Goldmann fields and 90% (18/20) for Humphrey fields (p=0.56). Patient questionnaire results revealed 70% (14/20) preferred Goldmann perimetry, 25% (5/20) preferred Humphrey perimetry, and 5% (1/20) had no preference. Conclusions: Goldmann and Humphrey perimetry are both effective in documenting VF loss associated with blepharoptosis: they are comparable in the amount of superior field loss detected and in their ability to detect >12° superior field loss at the 90° meridian. However, Goldmann perimetry requires less testing time and is preferred by most patients. Compared to previous research, we found a smaller test time difference between the two modalities. This could translate to improved office efficiency for practices that utilize either one or both methods. Reference: 1. Riemann CD, Hanson S, Foster JA. A comparison of manual kinetic and automated static perimetry in obtaining ptosis fields. Arch Ophthalmol 2000;118:65–69.
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