Abstract
Abstract: :
Purpose: To evaluate our first results with Pulsar perimetry in patients with ocular hypertension and compare them with normal individuals. Methods: Pulsar perimetry is a new perimetric procedure which uses stimuli combining spatial resolution (SR) and contrast (C) for early glaucoma evaluation. Pulsar perimeter shows white round stimuli, 5º in diameter, 500 msec log, shaped as a wave decreasing in amplitude, in 66 locations. The stimuli scale combines SR and C in 36src units. The prototype has the ability to examine various visual functions (spatial resolution, contrast perception, motion and temporal modulation), which theoretically excite large ganglion cells. The magnocellular system is thought to be affected prematurely in glaucoma. A temporal modulation program with pulsing stimuli at 30 Hz (phase-counter-phase oscillations) was used (program T30W). We studied 30 left eyes of 30 patients with ocular hypertension and normal G1 Octopus perimetry (mean age: 58,97 SD 9,25) and 30 left eyes of 30 normal individuals (mean age: 42,87 SD 16,11). A complete ophthalmologic examination, including temporal modulation Pulsar perimetry with TOP strategy, was performed for all patients. Exclusion criteria: visual acuity 3 spheric dp or 1,5 astigmatic dp, pupil size <3 mm, ocular surgery or pathologies, lens opacities, and non controlled diabetes or neurological diseases. They all had previous perimetric experience. Results were analyzed with t-test procedure. Results: For normal individuals, mean sensitivity (MS) for Pulsar perimetry was 21,21 src (spatial resolution and contrast units) with an SD of 4,66. Mean defect (MD) was 0,65 src SD 1,39 and loss variance (LV) was 5,96 src DS 4,16. For patients with ocular hypertension: MS was 17,64 src SD 2,74; MD was 3,59 src SD 2,45 and LV was 10,09 src SD 6,84. MS, MD and LV differences between the two groups were statistically significant (p<0,01) with 99% confidence limits of (0,94;6,20), (-4,30;-1,56;) and (-8,03; -0,24) respectively. Area under ROC curve obtained was of 0,84. Conclusion: Pulsar perimetry may have greater sensibility for the detection of early defects in patients with ocular hypertension than conventional perimetry.