Purchase this article with an account.
S.A. Newman; Automated Static Perimetry in the Young Pediatric Group: Lessons from the Nintendo Generation . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1953.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: A retrospective case controlled series was assembled from files at the University of Virginia to review the utility of automated static perimetry as a means of assessing the extrafoveal function in the young pediatric age group. Previous studies have demonstrated the ability of young children to perform automated static perimetry, but this is the first large-scale study of the usefulness of automated static perimetry in a clinical setting. Methods: 60,000 automated fields stored at the University of Virginia were screened for children of 10 years of age or younger. A total of 182 patients were selected. These patients had undergone a total of 542 visual fields. Fields were assessed for pattern of defect, reliability coefficients, and duration. Diagnoses were compared with results. Results: Most common diagnoses included intracranial tumor, optic disk changes, optic nerve pathology, craniofacial pathology, glaucoma and trauma. Visual field patterns most frequently included arcuate defects, diffuse depression in sensitivity, central scotomas, and homonymous defects. 476 fields were run with a 24-2 III size test object Of these 52 were run SITA Fast [SF] (duration 2:39 to 7:34 [mean 4:13]) and 419 were run Full Threshold [FT](3:23 to 25:21[mean 12:08]). Unacceptable false positives occurred in 33/419 [7.9%] FT and 4/52 [7.7%] SF. The false negative rate was statistically different: 44/419 [10.5%] FT and 1/52 [1.9%] SF. 5% pf visual fields were uninterpretable in spite of acceptable reliability coefficients Conclusions: Children of 10 or less are often capable of performing extraordinarily well with standard automated static perimetry programs. The introduction of SITA allows a tremendous decrease in the duration of the test with subsequent improvement in reliability coefficients (false negatives). A subgroup of patients, particularly those who are ill or with severe optic nerve or visual pathway pathology, remain poor candidates for automated perimetry. In particular, problems maintaining attention and fixation remain paramount. Automated static perimetry is an appropriate standard extrafoveal function assessment even in very young children.
This PDF is available to Subscribers Only