May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Fully automated kinetic perimetry as an alternative to standard static and kinetic perimetry
Author Affiliations & Notes
  • S.L. Pineles
    Department of Ophthalmology,
    University of Pennsylvania, Philadelphia, PA
  • N.J. Volpe
    Department of Ophthalmology,
    University of Pennsylvania, Philadelphia, PA
  • E. Miller–Ellis
    Department of Ophthalmology,
    University of Pennsylvania, Philadelphia, PA
  • S. Galetta
    Department of Neurology,
    University of Pennsylvania, Philadelphia, PA
  • P. Sankar
    Department of Ophthalmology,
    University of Pennsylvania, Philadelphia, PA
  • K. Schindler
    Department of Ophthalmology,
    University of Pennsylvania, Philadelphia, PA
  • M. Maguire
    Department of Ophthalmology,
    University of Pennsylvania, Philadelphia, PA
  • Footnotes
    Commercial Relationships  S.L. Pineles, None; N.J. Volpe, None; E. Miller–Ellis, None; S. Galetta, None; P. Sankar, None; K. Schindler, None; M. Maguire, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 239. doi:
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      S.L. Pineles, N.J. Volpe, E. Miller–Ellis, S. Galetta, P. Sankar, K. Schindler, M. Maguire; Fully automated kinetic perimetry as an alternative to standard static and kinetic perimetry . Invest. Ophthalmol. Vis. Sci. 2004;45(13):239.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose:Choices for formal visual field testing currently consist of automated static or manual kinetic examinations. It would be advantageous to create a standardized test that combines the benefits of both forms of perimetry, and that does not require a skilled perimetrist. Our goal was to design a fully automated test on the Octopus 101 perimeter that merges a short central static examination with a computer–driven peripheral kinetic examination, and to compare its results to standard perimetric methods. Methods: 56 neuro–ophthalmology or glaucoma patients (74 eyes) who had prior static (37 eyes) or kinetic (37 eyes) perimetry underwent testing. The test consisted of a tendency–oriented perimetry (TOP) examination that was completed first, and then overlain upon isopters delineated by a pre–programmed kinetic examination. Individual reaction time was calculated and used to correct the kinetic isopters. Three physicians, using a modified version of the OHTS trial classification scheme, classified the visual fields blindly and independently. The pairs were considered a match if the consensus analyses matched. Results: Of the 74 eyes, 37 were glaucoma (17 static, 20 kinetic) and 37 (20 static, 17 kinetic) were neuro–ophthalmology patients. Visual field pairs were classified as a match in 84% of the eyes with static comparisons and 78% of the eyes with kinetic comparisons. Upon inspection by a fourth grader, the non–matching sets largely consisted of visual fields for which a consensus was not reached, but that conveyed similar information. One subtle nasal step was detected by the kinetic component of the Octopus test that was missed by our Goldmann perimetrist. However, our perimetrist delineated small central scotomata in 2 glaucomatous eyes that were not delineated by the Octopus static component. Furthermore, there were 3 eyes in which a paracentral scotoma was slightly smaller on the Octopus test than on standard static testing. Patient preference was dependent upon the type of prior examination – patients preferred the Octopus test to standard static tests, but preferred manual kinetic testing overall. Conclusions: An unskilled technician can use the Octopus 101 as a method to combine static and kinetic perimetry in neuro–ophthalmology and glaucoma patients with complex visual field defects. Further studies are necessary to define its utility in patients with small central scotomata, and to determine whether this method is superior to static perimetry as a screening tool and for long–term follow–up.

Keywords: visual fields • neuro–ophthalmology: diagnosis • clinical (human) or epidemiologic studies: systems/equipment/techniques 
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