Abstract
Abstract: :
Purpose: To create a realistic computer–based training software for interactive kinetic perimetry teaching. Methods: This software is based on the original user interface of the new semi–automated kinetic perimetry (SKP) feature of the OCTOPUS 101 perimeter (HAAG–STREIT, Koeniz, CH). With the help of an adequate set of isopters the trainer creates a (pseudo) 3D individual "hill of vision" with a specific pathology. This hill may emanate from an actual perimetric record or is "moulded" according to the trainer's ideas. Response characteristics can be modified by altering the frequency of seeing curve, reaction time, fixation quality, ocular alignment, and pupil size of the artificial patient. The trainer may also enter details regarding patient's history, current complaints, morphological and functional findings into a comprehensive electronic medical chart, in which also images (e.g. fundus photographies) can be integrated. The trainee individually selects angular velocity and stimulus conditions according to the Goldmann classification (stimulus size I – V and luminance level 1a – 4e). He also independently defines origin, end and thereby direction of each kinetic target with the help of so–called vectors, which are entered by a computer mouse or an electronic pen on a touch screen. As soon as the kinetic stimulus, moving along a given vector, hits the previously defined hill of vision, this position is marked as "local kinetic threshold". Quality of the examination can be quantitatively assessed by the ratio of intersection area and union area of the individual trainee's result and the related trainer–defined original isopter. Ratio values for each chosen isopter together with other parameters of perimetric quality can be used to define a score, which allows for certification of the trainee, based on predefined standards. Results: In the meantime, more than twenty cases with representative scotoma patterns (e.g. hemianopic field loss, nerve fiber related defects, concentric constrictions, central scotoma), together with related patients' charts have been entered into the actual training software version. It has already been successfully used in perimetric courses. Conclusions: A computer–based interactive learning tool is demonstrated, which allows for certifyable education in kinetic perimetry, which is still the method of choice in expert opinion and neuro–ophthalmology, especially in case of advanced visual loss.
Keywords: perimetry • visual fields • computational modeling