Visual field indices and patterns of visual field deficits in mesopic and dark-adapted two-colour fundus-controlled perimetry in macular diseases

Background/AimsTo analyse the retest reliability of visual field indices and to describe patterns of visual field deficits in mesopic and dark-adapted two-colour fundus-controlled perimetry (FCP) in macular diseases.MethodsSeventy-seven eyes (30 eyes with macular diseases and 47 normal eyes) underwent duplicate mesopic and dark-adapted two-colour FCP (Scotopic Macular Integrity Assessment, CenterVue). Non-weighted (mean defect, loss variance), variability-weighted (mean deviation, pattern standard deviation (PSD)) and graphical (cumulative defect (Bebie) curves) indices were computed. Reproducibility (coefficient of repeatability, CoR) of these indices was assessed. Cluster analysis was carried out to identify patterns of visual field deficits.ResultsThe intrasession reproducibility was lower for the mean defect as compared with the mean deviation (CoR (dB) 2.67 vs 2.57 for mesopic, 1.71 vs 1.45 for dark-adapted cyan, 1.94 vs 1.87 for dark-adapted red testing) and lower for the square-root loss variance as compared with the PSD (CoR (dB) 1.48 vs 1.34, 0.77 vs 0.65, 1.23 vs 1.03). Hierarchical cluster analysis of the indices disclosed six patterns of visual field deficits (approximately unbiased P value>0.95) with varying degrees of global versus focal defect and rod versus cone dysfunction. These were also reflected by the cumulative defect curves.ConclusionFCP with mesopic and dark-adapted two-colour testing allows for reproducible assessment of different types of retinal sensitivity, whereby mean deviation and PSD exhibited the better retest reliability of the tested indices. Distinct patterns of retinal dysfunction can be identified using this setup, reflecting variable degrees of rod and cone dysfunction in different macular diseases. Dark-adapted two-colour FCP provides additional diagnostic information and allows for refined structure–function correlation in macular diseases.

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Correlation between fundus autofluorescence and visual function in patients with cone-rod dystrophy

Scientific Reports ◽

10.1038/s41598-021-81597-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Satoru Kanda ◽

Takumi Hara ◽

Ryosuke Fujino ◽

Keiko Azuma ◽

Hirotsugu Soga ◽

...

Keyword(s):

Visual Field ◽

Significant Relationship ◽

Fundus Autofluorescence ◽

Univariate Analysis ◽

Retrospective Chart Review ◽

Mean Deviation ◽

Wide Field ◽

The Mean ◽

The Relationship ◽

Field Imaging

AbstractThis study aimed to investigate the relationship between autofluorescence (AF) signal measured with ultra-wide field imaging and visual functions in patients with cone-rod dystrophy (CORD). A retrospective chart review was performed for CORD patients. We performed the visual field test and fundus autofluorescence (FAF) measurement and visualized retinal structures with optical coherence tomography (OCT) on the same day. Using binarised FAF images, we identified a low FAF area ratio (LFAR: low FAF/30°). Relationships between age and logMAR visual acuity (VA), central retinal thickness (CRT), central choroidal thickness (CCT), mean deviation (MD) value, and LFAR were investigated. Thirty-seven eyes of 21 CORD patients (8 men and 13 women) were enrolled. The mean patient age was 49.8 years. LogMAR VA and MD were 0.52 ± 0.47 and − 17.91 ± 10.59 dB, respectively. There was a significant relationship between logMAR VA and MD (p = 0.001). LogMAR VA significantly correlated with CRT (p = 0.006) but not with other parameters. Conversely, univariate analysis suggested a significant relationship between MD and LFAR (p = 0.001). In the multivariate analysis, LFAR was significantly associated with MD (p = 0.002). In conclusion, it is useful to measure the low FAF area in patients with CORD. The AF measurement reflects the visual field deterioration but not VA in CORD.

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Relationship between mean follow-up intraocular pressure, rates of visual field progression and current target intraocular pressure guidelines

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317406 ◽

2020 ◽

pp. bjophthalmol-2020-317406

Author(s):

Bruna Melchior ◽

Carlos Gustavo De Moraes ◽

Jayter S Paula ◽

George A Cioffi ◽

Christopher A Girkin ◽

...

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Treatment Guidelines ◽

Evaluation Study ◽

Mean Deviation ◽

Racial Groups ◽

Current Guideline ◽

Registration Number ◽

The Mean

AimsTo investigate if eyes presenting intraocular pressure (IOP) within the limits of current guideline-driven target IOP indeed experience slow rates of glaucomatous visual field (VF) progression.MethodsA total of 8598 24-2 VF tests from 603 eyes from the African Descent and Glaucoma Evaluation Study with manifest glaucoma were included. The sample was split into three groups based on baseline VF mean deviation (MD): G1 (better than −5.0 dB), G2 (−5.0 to −10 dB) and G3 (worse than −10 dB). We investigated the relationship between existing target IOP guidelines and rates of MD progression in these groups.ResultsFor stable eyes, the medians and IQR of the mean follow-up IOP were G1=15.0 mmHg (IQR: 13.1 to 17.7), G2=13.2 mmHg (IQR: 11.6 to 14.3) and G3=11.9 mmHg (IQR: 10.1 to 13.8) (p<0.01). When considering the mean follow-up IOP within the limits proposed by current guidelines, the median MD slopes were: −0.20 dB/y (IQR: −0.43 to −0.02) for G1<21 mmHg, −0.19 dB/y (IQR: −0.51 to −0.01) for G2<18 mmHg and −0.15 dB/y (IQR: −0.47 to 0.05) for G3<15 mmHg (p=0.63). There were no significant differences between racial groups.ConclusionIn a sample of patients with manifest glaucoma, despite substantial variability between eyes, adherence to treatment guidelines helped slow the rates of global VF progression at various stages of disease.Trial registration numberclinicaltrials.gov Identifier: NCT00221923.

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Classification and Statistical Trend Analysis in Detecting Glaucomatous Visual Field Progression

Journal of Ophthalmology ◽

10.1155/2019/1583260 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Cristiana Valente ◽

Elisa D’Alessandro ◽

Michele Iester

Keyword(s):

Statistical Analysis ◽

Standard Deviation ◽

Visual Field ◽

Trend Analysis ◽

Open Angle Glaucoma ◽

Mean Deviation ◽

Threshold Strategy ◽

Visual Field Progression ◽

The Mean

Aim. To evaluate the agreement between different methods in detection of glaucomatous visual field progression using two classification-based methods and four statistical approaches based on trend analysis. Methods. This is a retrospective and longitudinal study. Twenty Caucasian patients (mean age 73.8 ± 13.43 years) with open-angle glaucoma were recruited in the study. Each visual field was assessed by Humphrey Field Analyzer, program SITA standard 30-2 or 24-2 (Carl Zeiss Meditec, Inc., Dublin, CA). Full threshold strategy was also accepted for baseline tests. Progression was analyzed by using Hodapp–Parrish–Anderson classification and the Advanced Glaucoma Intervention Study visual field defect score. For the statistical analysis, linear regression (r2) was calculated for mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI), and when it was significant, each series of visual field was considered progressive. We also used Progressor to look for a significant progression of each visual field series. The agreement between methods, based on statistical analysis and classification, was evaluated using a weighted kappa statistic. Results. Thirty-eight visual field series were analyzed. The mean follow-up time was 6.2 ± 1.53 years (mean ± standard deviation). At baseline, the mean MD was −7.34 ± 7.18 dB; at the end of the follow-up, the mean MD was −9.25 ± 8.65 dB; this difference was statistically significant (p<0.001). The agreement to detect progression was fair between all methods based on statistical analysis and classification except for PSD r2. A substantial agreement (κ = 0.698 ± 0.126) was found between MD r2 and VFI r2. With the use of all the statistical analysis, there was a better time-saving. Conclusions. The best agreement to detect progression was found between MD r2 and VFI r2. VFI r2 showed the best agreement with all the other methods. GPA2 can help ophthalmologists to detect glaucoma progression and to help in treatment decisions. PSD r2 was the worse method to detect progression.

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The correlation between the thickness of the inner macular layers and the mean deviation of the visual field in children with primary congenital glaucoma

Archivos de la Sociedad Española de Oftalmología (English Edition) ◽

10.1016/j.oftale.2019.07.006 ◽

2019 ◽

Vol 94 (11) ◽

pp. 536-539

Author(s):

M. Nieves-Moreno ◽

S. García-Caride ◽

L. Morales-Fernandez ◽

J.M. Martínez-de-la-Casa ◽

F. Sáenz-Francés ◽

...

Keyword(s):

Visual Field ◽

Congenital Glaucoma ◽

Mean Deviation ◽

Primary Congenital Glaucoma ◽

The Mean

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Comparison of Perimetric Outcomes from Melbourne Rapid Fields Tablet Perimeter Software and Humphrey Field Analyzer in Glaucoma Patients

Journal of Ophthalmology ◽

10.1155/2020/8384509 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Harsh Kumar ◽

Mithun Thulasidas

Keyword(s):

Standard Deviation ◽

Visual Field ◽

Rural Areas ◽

Visual Fields ◽

Test Time ◽

Mean Deviation ◽

Time Saving ◽

Humphrey Field Analyzer ◽

Probability Plot ◽

The Mean

Purpose. To compare visual field results obtained using Melbourne Rapid Fields (MRF) iPad-based perimeter software and Humphrey Field Analyzer (HFA) 24-2 Swedish Interactive Threshold Algorithm (SITA) standard program in glaucoma patients. Design. A cross-sectional observational study. Methods. In this single-centre study involving patients diagnosed with glaucoma, the perimetric outcomes of MRF were compared against those returned from the HFA 24-2 SITA standard. Outcomes included mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI)/visual capacity (VC), foveal threshold, test time, number of points depressed at P<5% on PSD probability plot, and glaucoma hemifield test/color coded indicator. Results. The study included 28 eyes of 28 glaucoma patients. Mean (standard deviation) test times were 342.07 (56.70) seconds for MRF and 375.11 (88.95) for HFA 24-2 SITA standard P=0.046. Mean MD was significantly lower for MRF (Δ = 3.09, P<0.001), and mean PSD was significantly higher for MRF (Δ = 1.40, P=0.005) compared with HFA. The mean foveal threshold for the MRF was significantly lower than the mean HFA foveal threshold ((Δ = 9.25, P<0.001). The number of points depressed at P<5% on the PSD probability plot was significantly less for MRF P<0.001. Other perimetric outcomes showed no significant differences between both. Bland–Altman plots showed that considerable variability existed between the programs. Conclusion. MRF is a good cost-effective, time-saving, user-friendly tool for monitoring visual fields in settings where access to traditional perimetry is limited. The lack of Internet strength in rural areas and questionable detection of early cases may be two points in MRF fields requiring an upgrade.

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The Effect of Contact Lens–spectacle Reversed Galilean Telescope on the Visual Field of Patients with Open-angle Glaucoma

Journal of Ophthalmic and Vision Research ◽

10.18502/jovr.v15i4.7779 ◽

2020 ◽

Author(s):

Mohammadreza Moniritilaki ◽

Maryam Badakhsh ◽

Asieh Ehsaei ◽

Ramin Daneshvar

Keyword(s):

Visual Field ◽

Contact Lens ◽

Open Angle Glaucoma ◽

Field Measurements ◽

Visual Field Defects ◽

Mean Deviation ◽

Open Angle ◽

A Value ◽

Before And After ◽

The Mean

Purpose: Glaucoma causes irreversible visual field defects. This study aims to evaluate the effect of a reversed Galilean telescope on the visual field of patients with open-angle glaucoma. Methods: Fifty-two glaucoma patients with a restricted visual field were recruited for this study. Central 30° visual field measurements were performed using a Humphrey visual field analyzer before and after applying the reversed Galilean telescope. To be more cosmetically acceptable, a combination of contact lens–spectacle was used as the reversed Galilean telescope. Results: Our data analysis showed that the reversed Galilean telescope had a significant effect on all measured perimetric indices. Visual field index (VFI) improved from a basic value of 44.38 ± 26.96 percent to 49.30 ± 29.83 percent by using the reversed telescope (P < 0.001). Moreover, the mean deviation (MD) was significantly improved from the initial value of –19.91 ± 7.19 dB to a value of –18.69 ± 7.73 dB (P < 0.001). However, our results showed a significant reduction in the pattern standard deviation (PSD) comparing before (9.83 ± 2.82) and after (8.51 ± 3.30) values using the reversed Galilean telescope (P < 0.001). Conclusion: The contact lens–spectacle combination reversed Galilean telescope significantly improved the central 30° visual field of glaucoma patients with the restricted visual field.

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Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP: A Retrospective Study

10.21203/rs.2.17700/v1 ◽

2019 ◽

Author(s):

Lin Fu ◽

Yau Kei Chan ◽

Junhua Li ◽

Li Nie ◽

Na Li ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Retrospective Study ◽

Visual Field ◽

Cataract Surgery ◽

Final Visual Acuity ◽

Mean Deviation ◽

The Mean ◽

End Stage

Abstract Background: To investigate the long term surgical outcomes of cataract surgery in severe and end glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors. Methods: A retrospective study of severe and end stage glaucoma patients who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Twenty patients (24 eyes) were included. The mean age was 64.6 ± 11.0 years and the mean followed up duration was 21.4 ± 7.3 months. The final visual acuity was significantly improved from 0.93±0.72 to 0.70±0.74, within 14 (58.3%) eyes improved, 5 (20.8%) eyes kept unchanged, and 5 (20.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with greater final visual acuity improvement (r = -0.545, r = -0.501, r = 0.521 respectively). Moreover, the final number of medications were reduced from 1.1 ± 0.9 to 0.2 ± 0.5 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 13.2 ± 3.9 (6.8-25.9) mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was reduced to 7 (29.2%) eyes compared to 11 (45.8%) eyes at baseline. Moreover, the number of eyes without the use of medications was increased from 6 (25%) preoperatively to 20 (83.3%) eyes postoperatively. Conclusions: Final visual acuity was significantly improved in the severe and end stage glaucoma patients and the number of eyes came off medications increased by 58.3% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the visual acuity changes after cataract surgery.

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Evaluation of Visual Field and Balance Function Alterations in Patients Who Underwent Dermatochalasis Surgery

Journal of Ophthalmology ◽

10.1155/2020/1310947 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Melih Akidan ◽

Deniz Turgut Coban ◽

Muhammet Kazım Erol ◽

Uğur Balci

Keyword(s):

Visual Field ◽

Peripheral Vision ◽

Macular Thickness ◽

Balance Function ◽

Upper Eyelid ◽

The Mean ◽

Falling Risk ◽

Significant Change ◽

Balance Functions ◽

Loss Variance

Purpose. To compare perioperative visual field (VF), balance functions (BF), and changes in the other ocular parameters in patients undergoing upper eyelid dermatochalasis (DC) surgery. Methods. One hundred and fifty-eight eyes of 79 patients who underwent DC surgery were included in the study. The VF, BF, intraocular pressure (IOP), pachymetry (PM), macular, and optic nerve measurements were recorded. Measurements were repeated at postoperative month 1. The preoperative and postoperative ocular measurements and the balance data were compared. Results. Nineteen of 79 (24.05%) patients were male and 60 of 79 (75.95%) were female, while the mean age of the patients was 58.65 ± 7.38 years. There were statistically significant differences in terms of VF and macular thickness between the preoperative and postoperative values. The improvements in mean defect, standard loss variance, and mean sensitivity values of global VF parameters in both eyes were statistically significant after surgery. Central macular thickness, mean macular thickness, and macular volume decreased significantly in all eyes after surgery (p<0.05). Conclusions. Although a marked improvement was observed in VF and peripheral vision after surgery, no significant change was found in BF parameters including primarily falling risk. The significant change in the macular parameters was only remarkable, and we think that the decrease was due to subtle vasospasm. There is a need for further comprehensive studies including especially patients older than 65 with a view to understanding the effect of DC surgery on BF.

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Studying the role of 10-2 visual field test in different stages of glaucoma

European Journal of Ophthalmology ◽

10.1177/1120672119836904 ◽

2019 ◽

Vol 30 (4) ◽

pp. 706-713 ◽

Cited By ~ 1

Author(s):

Reham Hosny Tomairek ◽

Safaa Awadallah Aboud ◽

Mansour Hassan ◽

Alyaa H Mohamed

Keyword(s):

Visual Field ◽

Visual Function ◽

Precise Measurement ◽

Mean Deviation ◽

Visual Field Test ◽

Glaucoma Diagnosis ◽

Prospective Comparative Study ◽

The Mean ◽

Early Damage

Objective: To assess the role of 10-2 visual field (VF) test in different stages of glaucoma. Methods: In our prospective comparative study, 24-2 and 10-2 VF tests were done for 115 eyes with different stages of glaucomatous damage or glaucoma suspects. Optical coherence tomography (OCT) was performed in 79 eyes. We compared field changes of the central 10° on 10-2 and 24-2 tests and studied the correlation between the mean deviation (MD) measured by the two tests. Results: In seven glaucoma suspects, glaucoma diagnosis was missed by 24-2 test but was detected by 10-2 test and confirmed by OCT. In the eyes with early damage, there was no correlation between 10-2 and 24-2 tests regarding the MD of the central 10º. In moderate and severe stages, there was a significant correlation between the results of 24-2 and 10-2 tests. Conclusion: We concluded that 10-2 test could help confirm glaucoma diagnosis in glaucoma suspects missed by 24-2 test before resorting to the more expensive OCT. In early glaucoma, we noted that 10-2, as confirmed by OCT, was a beneficial addition to 24-2 test for precise measurement of the MD and detection of defects of the central 10º missed by 24-2 test, where more intense treatment should be considered to preserve the threatened central visual function. In moderate and severe cases, the role of 10-2 test was not as pivotal as in early cases, but still it was useful for assessment of residual central visual function in severe cases with absolute central 10º defects on 24-2 test for proper management.

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Aqueous Humor Proteomic Alterations Associated with Visual Field Index Parameters in Glaucoma Patients: A Pilot Study

Journal of Clinical Medicine ◽

10.3390/jcm10061180 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1180

Author(s):

Sai Karthik Kodeboyina ◽

Tae Jin Lee ◽

Kathryn Bollinger ◽

Lane Ulrich ◽

David Bogorad ◽

...

Keyword(s):

Visual Field ◽

Aqueous Humor ◽

Molecular Mechanisms ◽

Visual Fields ◽

Mean Deviation ◽

Glaucomatous Optic Neuropathy ◽

Visual Field Index ◽

Liquid Chromatography Tandem Mass ◽

Visual Field Indices ◽

Apolipoprotein D

Purpose: The purpose of this study was to discover the aqueous humor proteomic changes associated with visual field indices in glaucoma patients. Methods: Aqueous humor samples were analyzed using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS). The visual fields were analyzed with the Humphrey Visual Field analyzer. Statistical analyses were performed to discover the relationship between the aqueous humor proteins and visual field parameters including Pattern Standard Deviation (PSD), Visual Field Index (VFI), Mean Deviation (MD) and Glaucoma Hemifield Test (GHT). Results: In total, 222 proteins were identified in 49 aqueous humor samples. A total of 11, 9, 7, and 6 proteins were significantly correlated with PSD, VFI, MD, and GHT respectively. These proteins include apolipoprotein D, members of complement pathway (C1S, C4A, C4B, C8B, and CD14), and immunoglobulin family (IKHV3-9, IGKV2-28). Conclusion: Several proteins involved in immune responses (immunoglobulins and complement factors) and neurodegeneration (apolipoprotein D) were identified to be associated with abnormal visual field parameters. These findings provide targets for future studies investigating precise molecular mechanisms and new therapies for glaucomatous optic neuropathy.

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