Changes of Peripapillary Region Perfusion in Patients with Chiasmal Compression Caused by Sellar Region Mass

Purpose. To evaluate the peripapillary vessel density (pVD) and the peripapillary nerve fiber layer (pRNFL) thickness in patients with chiasmal compression caused by sellar region mass using optical coherence tomography angiography (OCTA). Methods. This is an observational, cross-sectional study of 31 patients (31 eyes) with chiasmal compression caused by sellar region mass and 34 healthy controls (34 eyes). Automated perimetry and OCTA were performed. The pVD and pRNFL thickness were compared between the two groups. The impact of tumor diameter, duration of symptoms, and cavernous sinus (CS) invasion on visual dysfunction, pVD, and pRNFL thickness was also analyzed. Furthermore, we divided the patients into two subgroups according to whether there was an absolute defect in the central visual field and evaluated their pVD and pRNFL thickness, respectively. Results. Compared to the healthy control group, there was a statistically significant decrease in pVD and pRNFL thickness in patients with chiasmal compression ( p < 0.05 ), especially in patients with substantial absolute defects in the central visual field. Tumor diameter, duration of symptoms, and CS invasion did not appear to be associated with pVD and pRNFL thickness. There was a significant positive correlation between the pVD and pRNFL thickness in patients with chiasmal compression ( p < 0.001 ). Conclusion. pVD and pRNFL thickness are significantly decreased in patients with chiasmal compression revealed by OCTA, especially in patients with more severe visual field defects. A significant correlation between pVD and pRNFL thickness was demonstrated, which provides a clue for the study of the mechanism of changes in retinal perfusion in compressive optic neuropathy. It requires considerable attention that OCTA may play an important role in disease monitoring of sellar region mass. Hence, further studies are needed to verify whether OCTA is helpful to predict the prognosis of visual function after decompression surgery.

Download Full-text

Essentials of Automated Perimetry

Visual Fields ◽

10.1093/oso/9780195389685.003.0008 ◽

2010 ◽

Author(s):

George Shafranov

Keyword(s):

Visual Field ◽

Digital Data ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Central Visual Field ◽

Kinetic Perimetry ◽

Field Of Vision ◽

Stationary Test ◽

Variable Light ◽

Defects Analysis

Standard automated perimetry is a standard method of measuring peripheral visual function. Automated static perimetry gained wide acceptance among clinicians due to the test’s high reproducibility and standardization and ability to store, exchange, and statistically analyze digital data. Advances in the computerized visual field assessment have contributed to our understanding of the role that field of vision plays in clinical evaluation and management of patients. The Humphrey Visual Field Analyzer/HFA II-i is the most commonly used automated perimeter in the United States, and the examples in this chapter have been obtained with this instrument. Aubert and Förster in the 1860s developed the arc perimeter, which led to the mapping of peripheral neurologic visual field abnormalities and advanced glaucomatous field defects. Analysis of the central visual field was not seen as clinically important by most clinicians until 1889, when Bjerrum described a detected arcuate paracentral scotoma. Later, Traquair further contributed to kinetic perimetry on the tangent screen. In 1893, Groenouw proposed the term “isopter” for lines with the same sensitivity on a perimetry chart. Rønne further developed kinetic isopter perimetry in 1909 and described the nasal step in glaucoma. Although the first bowl perimeter was introduced in 1872 by Scherk, due to problems with achieving even illumination on the screen, it did not become popular. The version of the bowl perimeter introduced by Goldmann in 1945 became widely accepted and is a significant contribution to clinical perimetry. The Goldmann perimeter incorporated a projected stimulus on an illuminated bowl, with standardization of background illumination as well as size and intensity of the stimulus, and allowed effective use of both static and kinetic techniques. For these reasons, the Goldmann instrument has remained the clinical standard throughout the world until widespread acceptance of automated perimetry. Harms and Aulhorn later designed the Tübingen perimeter with a bowl-type screen exclusively for the measurement of static threshold fields, using stationary test objects with variable light intensity. While excellent threshold measurements were possible with this instrument, the time and effort involved in such measurements prevented this perimeter from becoming widely used.

Download Full-text

Impact of Visual Field Testing on Intraocular Pressure Change Trends in Healthy People and Glaucoma Patients

Journal of Ophthalmology ◽

10.1155/2020/7936205 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Mengwei Li ◽

Bingxin Zheng ◽

Qi Wang ◽

Xinghuai Sun

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Repeated Measures ◽

Healthy Subjects ◽

Open Angle Glaucoma ◽

Field Testing ◽

Automated Perimetry ◽

Open Angle ◽

Standard Automated Perimetry ◽

The Impact

Purpose. To compare the impact of visual field (VF) testing on intraocular pressure (IOP) change trends between healthy subjects and glaucoma patients. Methods. We recruited healthy volunteer subjects who did not have previous ocular diseases and open-angle glaucoma patients who were medically controlled well. IOP in both eyes of each participant was measured by using a noncontact tonometer at five time points: before, immediately after (0 minute), and 10, 30, and 60 minutes after the standard automated perimetry. Repeated measures ANOVA was used to analyze the effect of VF testing on IOP change trends in healthy and glaucoma eyes. Results. Forty healthy subjects (80 eyes) and 31 open-angle glaucoma patients (62 eyes) were included for the study. The baseline IOP of healthy and glaucoma eyes was 16.11 ± 3.01 mmHg and 15.78 ± 3.57 mmHg, respectively. After the VF testing, the IOP in healthy eyes was decreased by 1.5% at 0 minute, 6.5% at 10 minutes (P<0.001), 6.6% at 30 minutes (P<0.001), and 7.0% at 1 hour (P<0.001), indicating that this reduction was sustained for at least 1 hour. However, the IOP in glaucoma eyes was increased by 12.7% at 0 minute (P<0.001) and, then, returned towards initial values 1 hour after the VF testing. Conclusions. IOP change trends after VF field testing between healthy subjects and glaucoma patients were quite different. VF testing led to a mild and relatively sustained IOP decrease in healthy subjects, whereas IOP in open-angle glaucoma patients tended to significantly increase immediately after VF testing and, then, returned to pretest values after 1 hour. These findings indicate that the factors of VF testing should be considered in the clinical IOP measurements.

Download Full-text

Compass fundus automated perimetry

European Journal of Ophthalmology ◽

10.1177/1120672118757667 ◽

2018 ◽

Vol 28 (5) ◽

pp. 481-490 ◽

Cited By ~ 1

Author(s):

Paolo Fogagnolo ◽

Maurizio Digiuni ◽

Giovanni Montesano ◽

Chiara Rui ◽

Marco Morales ◽

...

Keyword(s):

Visual Field ◽

Visual Fields ◽

Field Testing ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Gaze Tracking ◽

Intrinsic Factors ◽

Global Indices ◽

Humphrey Field Analyzer ◽

The Impact

Background: Compass (CenterVue, Padova, Italy) is a fundus automated perimeter which has been introduced in the clinical practice for glaucoma management in 2014. The aim of the article is to review Compass literature, comparing its performances against Humphrey Field Analyzer (Zeiss Humphrey Systems, Dublin, CA, USA). Results: Analyses on both normal and glaucoma subjects agree on the fact that Humphrey Field Analyzer and Compass are interchangeable, as the difference of their global indices is largely inferior than test -retest variability for Humphrey Field Analyzer. Compass also enables interesting opportunities for the assessment of morphology, and the integration between morphology and function on the same device. Conclusion: Visual field testing by standard automated perimetry is limited by a series of intrinsic factors related to the psychophysical nature of the examination; recent papers suggest that gaze tracking is closely related to visual field reliability. Compass, thanks to a retinal tracker and to the active dislocation of stimuli to compensate for eye movements, is able to provide visual fields unaffected by fixation instability. Also, the instrument is a true colour, confocal retinoscope and obtains high-quality 60° × 60° photos of the central retina and stereo-photos details of the optic nerve. Overlapping the image of the retina to field sensitivity may be useful in ascertaining the impact of comorbidities. In addition, the recent introduction of stereoscopic photography may be very useful for better clinical examination.

Download Full-text

Central macular OCTA parameters in glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-319574 ◽

2021 ◽

pp. bjophthalmol-2021-319574

Author(s):

Takashi Nishida ◽

Won Hyuk Oh ◽

Sasan Moghimi ◽

Adeleh Yarmohammadi ◽

Huiyuan Hou ◽

...

Keyword(s):

Visual Field ◽

Mixed Model ◽

Linear Mixed Model ◽

Open Angle Glaucoma ◽

Foveal Avascular Zone ◽

Mean Deviation ◽

Automated Perimetry ◽

Central Visual Field ◽

Foveal Thickness ◽

Glaucoma Suspect

Background/aimsTo investigate the relationship between the foveal avascular zone (FAZ) parameters assessed by optical coherence tomography angiography (OCTA) and central visual field parameters in glaucoma and healthy subjects.MethodsOne hundred and eighty-eight subjects (248 eyes), including 24 healthy (38 eyes), 37 glaucoma suspect (42 eyes, and 127 primary open angle glaucoma (POAG) patients (168 eyes), underwent imaging using OCTA and standard automated perimetry using the 24-2 and 10-2 Swedish Interactive Thresholding Algorithm. OCTA-based and OCT-based FAZ parameters (superficial FAZ area, FAZ circumference), foveal vessel density (FD300) and foveal thickness were measured. The correlation between FAZ parameters and visual field parameters was assessed using linear mixed model.ResultsAxial length adjusted-FAZ area was not different among the three groups (mean (95% CI)): in healthy 0.31 (0.27 to 0.36) mm2, glaucoma suspect 0.29 (0.26 to 0.31) mm2 and POAG eyes 0.28 (0.27 to 0.30) mm2 (p=0.578). FD300 was lower in glaucoma suspect 49.1% (47.9% to 50.4%) and POAG eyes 48.7% (48.1% to 49.4%) than healthy eyes 50.5% (49.3% to 51.7%) though the difference was not statistically significant (p=0.071). Lower FD300 was associated with worse 24-2 and 10-2 visual field mean deviation and foveal threshold in multivariable linear mixed models (all p<0.05). In addition, a smaller FAZ area was associated with lower intraocular pressure (IOP) (p=0.026).ConclusionsThe FD300, but not the FAZ area was correlated with 10° central visual field mean deviation and foveal threshold in healthy, glaucoma suspect and POAG eyes. In contrast, a smaller FAZ area was associated with lower IOP.

Download Full-text

Long-Term Effects of Nilvadipine against Progression of the Central Visual Field Defect in Retinitis Pigmentosa: An Extended Study

BioMed Research International ◽

10.1155/2013/585729 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Mitsuru Nakazawa ◽

Yukihiko Suzuki ◽

Tadashi Ito ◽

Tomomi Metoki ◽

Takashi Kudo ◽

...

Keyword(s):

Visual Field ◽

Retinitis Pigmentosa ◽

Visual Field Defect ◽

Treated Group ◽

Control Group ◽

Long Term Effects ◽

Central Visual Field ◽

The Mean ◽

Field Defect

Purpose. To assess the long-term effects of nilvadipine on the progression of central visual field defect in retinitis pigmentosa (RP).Methods. Patients with RP were randomly divided into a treated group receiving oral nilvadipine and a control group. Progression of RP was evaluated with MD slope and the average sensitivity of the central 2° (ΔCENT4).Results. The mean MD slopes were −0.55/−0.39 (right/left eyes,n=19) dB/year in the treated group and −1.37/−1.15 (right/left eyes,n=22) dB/year in the control group (P=0.016/0.050, resp.). In both eyes, however, no statistical difference was observed between the two groups for the ΔCENT4 values.Conclusion. Although we confirmed that nilvadipine significantly retarded the progression of the average of MD value defects in the central 10°, it was not specific for the central 2° of the visual field in RP.

Download Full-text

Agreement between the newly developed OCT glaucoma staging system and the standardized visual field glaucoma staging system 2

European Journal of Ophthalmology ◽

10.1177/11206721211014378 ◽

2021 ◽

pp. 112067212110143

Author(s):

Elshimaa A Mateen Mossa ◽

Heba Khallaf ◽

Khulood Muhammad Sayed

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

Staging System ◽

Control Group ◽

Ganglion Cell Complex ◽

Automated Perimetry ◽

Cross Sectional ◽

Stage 4 ◽

Staging Systems ◽

Stage 1

Purpose: The purpose of this research was to assess the agreement between the new optical coherence tomography (OCT) glaucoma staging system (GSS) and the visual field (VF) GSS 2 (GSS2). Methods: This is a cross-sectional study of 161 eyes of 110 patients with controlled primary open-angle glaucoma (POAG). All eyes were subjected to VF examination using standard automated perimetry and Humphrey field analyzer II 750. GSS2 was used for the classification of the VF defects’ severity. OCT of the optic disc and the macular ganglion cell complex (GCC) was performed using RTVue. Patients were classified by OCT GSS into six stages. Results: The study examined 161 eyes of 110 patients with controlled POAG. The staging according to VF GSS2 was as follows: stage 0 (12.42%), border stage (12.42%), stage 1 (13.04%), stage 2 (14.29%), stage 3 (14.28%), stage 4 (14.28%), and stage 5 (19.25%). The staging by OCT GSS was as follows: stage 0 (18.6 %), border stage (17.3%), stage 1 (6.8%), stage 2 (9.31%), stage 3 (6%), stage 4 (11.8%), and stage 5 (30.43%). The sensitivity of the new OCT GSS was different in different stages of glaucoma. In this study, no normal control group was considered; thus, the specificity could not be calculated. There was moderate agreement between the two staging systems. Conclusions: OCT GSS is a reliable and objective method for diagnosing and monitoring glaucoma. Correlations were found between GSS2, inferior and total macular GCC thickness values, and cup-to-disc ratios, so considering these items as additional parameters may make this new classification even more sensitive than VF GSS2.

Download Full-text

Influence of automated visual field testing on intraocular pressure

10.21203/rs.3.rs-21287/v1 ◽

2020 ◽

Author(s):

Samuel Bertaud ◽

Elisabeth Skarbek Borowski ◽

Rachid Abbas ◽

Christophe Baudouin ◽

Antoine Labbé

Keyword(s):

Intraocular Pressure ◽

Visual Field ◽

Open Angle Glaucoma ◽

Corneal Thickness ◽

Angle Closure ◽

Mean Deviation ◽

Test Duration ◽

Automated Perimetry ◽

Significant Difference ◽

The Impact

Abstract Background To evaluate the influence of automated visual field (VF) testing on intraocular pressure (IOP) in patients with ocular hypertension (OHT) or glaucoma. Methods We conducted a prospective observational study from October 2015 to July 2016 at Quinze-Vingts National Ophthalmology Hospital in Paris. Ninety-five right eyes of 95 patients followed for glaucoma or OHT with reliable standard automated perimetry (SAP) were included. IOP was measured three times using a Nidek NT-510 non-contact tonometer within a maximum of 5 minutes before and after VF testing. Subanalyses using logistic regression analysis were performed to evaluate the impact of gender, age, central corneal thickness (CCT), mean deviation (MD) of the VF, VF test duration and filtration surgery on IOP fluctuations. Results There was no significant change in IOP after VF testing, with IOP’s 15.14 ± 4.00 mmHg before and 14.98 ± 3.33 mmHg after the VF (P = 0.4). The average change in IOP was 0.15 ± 1.82 mmHg. Using multivariate analysis, no effect of the VF test on IOP was found (global model fit R²=0.12), whether based on duration of the VF test (P = 0.18) or the MD (P = 0.7) after adjustment for age, gender, CCT and history of glaucoma surgery. Similarly, there was no significant difference within different types of glaucoma, including open-angle glaucoma (p = 0.36), chronic angle closure glaucoma (P = 0.85) and OHT (P = 0.42). The subgroup of patients with an IOP elevation > 2 mmHg had a significantly higher SAP test duration (P = 0.002). Conclusion VF testing by SAP does not influence IOP as measured with a non-contact tonometer.

Download Full-text

Evaluation of the New Compression-Perimeter Test Effectiveness in the Early Diagnosis of Glaucoma

Ophthalmology in Russia ◽

10.18008/1816-5095-2020-2-229-237 ◽

2020 ◽

Vol 17 (2) ◽

pp. 229-237

Author(s):

V. V. Volkov ◽

I. L. Simakova ◽

I. A. Tikhonovskaya

Keyword(s):

Visual Field ◽

Early Diagnosis ◽

Early Stage ◽

Open Angle Glaucoma ◽

Standard Stimulus ◽

International Standards ◽

Control Group ◽

Ophthalmological Examination ◽

Stress Tests ◽

Central Visual Field

Purpose: To evaluate the effectiveness of a new modification of the vacuum-perimeter test (VPT) by V.V. Volkov in the early diagnosis of glaucoma in comparison with the results of the original test and its known modification — vacuum-compression automated test (VCAT) in an open comparative clinical research. Patients and Methods. The study involved 26 patients (47 eyes) (average age 52.9 ± 8.5 years) with suspected open-angle glaucoma (OAG). Patients were divided into three groups: 1-st — 19 eyes with preglaucoma, 2-nd — 18 eyes with the early stage of OAG, 3-rd — 10 eyes of five patients with unconfirmed glaucoma. The control group (4-th) included 20 eyes of 10 healthy people (average age 56.4 ± 4.4 years). Along with the standard ophthalmological examination, all patients underwent perimetry on Humphrey Visual Field Analyzer II 745i (Germany-USA), our modification of Frequency Doubling Technology (FDT) perimetry, evaluation of the optic nerve head (ONH) on Heidelberg Retina Tomograph (HRT 3, Germany) and three stress tests: VPT, VCAT and our modification — vacuum-contrast-frequency test (VCFT). VCFT was created on the base of FDT perimetry with the aim of increasing the sensitivity of the original test (VPT) for detection of preglaucoma through the use of non-standard stimulus and increasing the number of investigated points of central visual field. Results. According to the National classification (1975) the diagnosis of preglaucoma was determined on the basis of a positive result of at least one of three stress tests, taking into account the risk factors for the development of glaucoma in patients. The early stage of OAG was established on the base of International standards for structural and functional assessment of the ONH (2003). The specificity of all three compared stress tests was 100 %, which confirmed their negative results in all patients (10 eyes) from the 3-rd group. However, the sensitivity of VCFT (75 %) was significantly higher than VPT (21.05 %) and VCAT (21.05 %), which is due, we believe, to the specific nature of VCFT stimulus. Conclusion. According to the obtained data, the developed new modification of VPT — VCFT on the specificity of the results was not worse, and the sensitivity was better than the original VPT and VCAT in the diagnosis of preglaucoma. VCFT is quickly performed and comfortable for patients.

Download Full-text

Mapping Visual Field Defects With fMRI – Impact of Approach and Experimental Conditions

Frontiers in Neuroscience ◽

10.3389/fnins.2021.745886 ◽

2021 ◽

Vol 15 ◽

Author(s):

Gokulraj T. Prabhakaran ◽

Khaldoon O. Al-Nosairy ◽

Claus Tempelmann ◽

Hagen Thieme ◽

Michael B. Hoffmann

Keyword(s):

Visual Field ◽

Sensitivity And Specificity ◽

Color Change ◽

Visual Stimulation ◽

Block Design ◽

Visual Field Defects ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Experimental Conditions ◽

The Impact

Current initiatives to restore vision emphasize the need for objective assessments of visual field (VF) defects as pursued with functional magnetic resonance imaging (fMRI) approaches. Here, we compared population receptive field (pRF) mapping-based VF reconstructions to an fMRI method that uses more robust visual stimulation (on-off block design) in combination with individualized anatomy-driven retinotopic atlas-information (atlas-based VF). We investigated participants with sizable peripheral VF-deficits due to advanced glaucoma (n = 4) or retinitis pigmentosa (RP; n = 2) and controls (n = 6) with simulated scotoma. We obtained (1) standard automated perimetry (SAP) data as reference VFs and 3T fMRI data for (2) pRF-mapping [8-direction bar stimulus, fixation color change task] and (3) block-design full-field stimulation [8-direction drifting contrast patterns during (a) passive viewing (PV) and (b) one-back-task (OBT; reporting successions of identical motion directions) to probe the impact of previously reported task-related unspecific visual cortex activations]. Correspondence measures between the SAP and fMRI-based VFs were accuracy, assisted by sensitivity and specificity. We found an accuracy of pRF-based VF from V1 in patients [median: 0.62] that was similar to previous reports and increased by adding V2 and V3 to the analysis [0.74]. In comparison to the pRF-based VF, equivalent accuracies were obtained for the atlas-based VF for both PV [0.67] and, unexpectedly, the OBT [0.59], where, however, unspecific cortical activations were reflected by a reduction in sensitivity [0.71 (PV) and 0.35 (OBT)]. In conclusion, in patients with peripheral VF-defects, we demonstrate that previous fMRI procedures to obtain VF-estimates might be enhanced by: (1) pooling V1-V3 to enhance accuracy; (2) reporting sensitivity and specificity measures to increase transparency of the VF-reconstruction metric; (3) applying atlas-based procedures, if pRF-based VFs are not available or difficult to obtain; and (4) giving, counter-intuitively, preference to PV. These findings are expected to provide guidance to overcome current limitations of translating fMRI-based methods to a clinical work-up.

Download Full-text

Alterations Induced by Bangerter Filters on the Visual Field: A Frequency Doubling Technology and Standard Automated Perimetry Study

Journal of Ophthalmology ◽

10.1155/2015/909848 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8

Author(s):

Costantino Schiavi ◽

Filippo Tassi ◽

Alessandro Finzi ◽

Mauro Cellini

Keyword(s):

Visual Field ◽

Frequency Doubling ◽

Control Group ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Parvocellular Pathway ◽

Anisometropic Amblyopia ◽

Frequency Doubling Technology ◽

Normal Adults

Purpose. To investigate the effects of Bangerter filters on the visual field in healthy and in amblyopic patients.Materials and Methods. Fifteen normal adults and fifteen anisometropic amblyopia patients were analysed with standard automated perimetry (SAP) and frequency doubling technology (FDT) at baseline and with filters 0.8 and 0.1.Results. With 0.1 filter in SAP there was an increase of MD compared with controls (−10.24 ± 1.09 dB) in either the amblyopic (−11.34 ± 2.06 dB;P<0.050) or sound eyes (−11.34 ± 1.66 dB;P<0.030). With filters 0.8 the PSD was increased in the amblyopic eyes (2.09 ± 0.70 dB;P<0.007) and in the sound eyes (1.92 ± 0.29 dB;P<0.004) compared with controls. The FDT-PSD values in the control group were increased with the interposition of the filters compared to baseline (0.8;P<0.0004and 0.1;P<0.0010). We did not find significant differences of the baseline PSD between amblyopic eyes (3.80 ± 2.21 dB) and the sound eyes (4.33 ± 1.31 dB) and when comparing the filters 0.8 (4.55 ± 1.50 versus 4.53 ± 1.76 dB) and 0.1 (4.66 ± 1.80 versus 5.10 ± 2.04 dB).Conclusions. The use of Bangerter filters leads to a reduction of the functionality of the magno- and parvocellular pathway.

Download Full-text