青光眼合并高度近視視野的改燮特徵

目的研究合并高度近视的青光眼和非高度近视的青光眼的视野改变有无差别。方法 利用Octopus 101全自动视野计对36例(51眼)合并高度近视的原发性开角型青光眼(primary open angle glaucoma,POAG)和16例(23眼)非高度近视的POAG进行静态中心阈值视野检查,并分析其视野缺损形式,视野缺损与生理盲点及固视点的关系和视野指数的改变。结果合并高度近视的POAG视野缺损形式与非高度近视的POAG视野缺损形式相似,差异无显著性(早期POAG,X~2=0.000138,P>0.05,中晚期POAG,X~2=1.1494,P>0.05)。合并高度近视的POAG视野缺损较多的与生理盲点相速或/和与固视点相近(或相连),但与非高度近视的POAG相比,差异无显著性(早期POAG,X~2=1.3892,P>0.05,中晚期POAG,X~2=2.6852,P>0.05)。随着近视度数的增加,MS值逐渐下降,MD和LV值逐渐升高。结论 合并高度近视的POAG视野缺损较多的与生理盲点和/或固视点相连或相近,近视度数越高,其视野损害越明显。     

青光眼阈值视野缺损的计分方法评价

目的：评价青光眼视野缺损计分方法的有效性和可靠性。方法：采用AGIS(Advanced Glaucoma Intervention Study)研究组推荐的计分方法并稍加改动对9l例(91眼)青光眼患者的视野进行计分，分析视野缺损计分值与C／D比、平均缺损(mean defect，MD)值及缺失方差（loss variance，LV)值的关系和相关性。结果：视野缺损计分值越大，C／D比、MD值及LV值亦越大，视野缺损计分值与C／D比呈明显的正相关（r=0．8712)，其相关系数大于MD值和LV值与C，D比的相关系数。结论：视野缺损计分法较视野指数能更准确地反映青光眼视神经损害情况，能对青光眼视野损害的程度进行量化表达。     

胞磷胆碱钠对青光眼患者视野损害的疗效观察

目的：观察胞磷胆碱钠(citicoline)对青光眼性视野损害的疗效。

方法：选择有视野缺损,眼压控制在18mmHg以下的青光眼患者。符合入选标准者共29例48眼,男16例27眼,女13例21眼; 其中原发性开角型青光眼25眼,闭角型青光眼19眼,正常眼压性青光眼4眼。使用胞磷胆碱钠片,每次0.2g口服,每日3次连续用药3mo。观察用药前后视野的变化。分别于用药后1mo及3mo检测视野平均敏感度(MS)、平均缺损值(MD)和丢失方差(LV)等指标,并与用药前进行比较。

结果：用药1mo后48眼的平均视敏度值(MS)明显高于用药前,差异有统计学意义(P<0.01); MD值明显低于用药前,差异有统计学意义(P<0.05)。用药3mo后,患者视野MS值明显高于用药前,差异有统计学意义(P<0.01); MD和LV值明显下降,差异有统计学意义(P<0.01)。

结论：胞磷胆碱钠对青光眼性视野损害有一定程度的保护作用。     

趋势导向视野检查法与常规阈值视野检查法的对比研究

目的 评价趋势导向视野检查法(tendency-oriented perimetry, TOP)在青光眼视功能检测中的应用价值。 方法 利用Octopus 101全自动视野计分别对20名正常人的20只正常眼、32例原发性开角型青光眼(primary open angle glaucoma, POAG)患者的32只患眼和14例可疑POAG患者的14只眼分别进行常规阈值视野检查(Normal/Normal程序)和TOP视野检查(TOP/Normal程序)。所有受检眼在2周内再次分别进行常规阈值视野检查和TOP视野检查。将两种视野检查的结果、视野检查指数、点对点阈值变异及视野缺损点数进行比较和分析。 结果 TOP视野检查正常人的阴性检出率为90%，POAG的阳性检出率为75%，其中检测中晚期POAG的阳性检出率达100％。2种视野检查的视野指数呈明显正相关，平均敏感度(mean sensitivity, MS)的相关系数为0.9335，平均缺损(mean defect, MD)的相关系数为0.9189，偏离缺失(loss variance, LV)的相关系数为0.9621。点对点阈值变异和视野缺损点数TOP视野检查结果略高于常规阈值视野检查结果，但二者间差异均无显著性的意义(P＝0.2019，P＝0.4448)。 结论 TOP视野检查指数与常规阈值视野检查指数呈明显正相关，其检测中晚期POAG的敏感性及可重复性高。 (中华眼底病杂志, 2002, 18: 169-272)     

高通分辨视野检查法对原发性开角型青光眼的早期诊断价值

目的探讨高通分辨视野检查法对青光眼的早期诊断价值。方法参照Ｆｒｉｓéｎ所介绍的方法，利用微型计算机设计适合检测青光眼早期视野缺损的高通分辨视野检查仪。并对２２例（４４只眼）正常人、２７例（４１只眼）自动视野检查异常的原发性开角型青光眼（ｐｒｉｍａｒｙｏｐｅｎａｎｇｌｅｇｌａｕｃｏｍａ，ＰＯＡＧ）及１０例（１３只眼）自动视野检查正常的早期或可疑ＰＯＡＧ进行高通分辨视野测量。结果正常人的平均分辨阈值为右眼３．９６±０．５５ｄＢ，左眼３．９８±０．５５ｄＢ。高通分辨视野检查对检测青光眼视野损害的敏感性高于常规的自动视野计检查，敏感性为９３．７５％，特异性为９７．７％，青光眼早期视野损害可表现为分辨阈值升高。结论高通分辨视野检查法是检测ＰＯＡＧ早期视野损害的敏感方法之一，值得推广应用。     

定量视野检查与形角型青光眼的早期诊断

应用Ｏｃｔｏｐｕｓ２０００Ｒ型自动静态定量视野计对１０５只眼进行定量视野检查的结果表明：在弧形和平面视野计检查发现异常的１９只青光眼中，定量视野计检查均有异常，视野损害类型以混合损害为主（１３／１９），损害分期多为中期（１０／１９）；在弧形和平面视野计检查未发现异常的４８只青光眼或原可疑青光眼中，定量视野计检查有３３只眼有异常，视野损害类型以混合损害和弥漫损害为主（２９／３３），损害分期多为早期…     

趋势导向视野检查与常规阈值视野检查的比较研究

目的比较趋势导向视野检查程序(Tendency Oriented Peri metrey,TOP)与常规视野检查程序对青光眼病人视野检查结果的差异,对IOP程序检查结果进行评价。方法用Ocutopus101电脑视野计对36例青光眼患者共46眼分别用常规阈值程序(Normal/Normal)和趋势导向(TOP)视野检查程序进行检查。将两种方法的视野检查结果进行分析比较。结果①36例青光眼患者共46眼,常规阈值程序检查均有视野损害,其中早期青光眼15眼,中晚期31眼。早期患者用TOP程序检查的阳性率为73%(11/15),中晚期患者TOP程序均能够发现视野损害,视野损害的部位两种程序有较高的一致性。②视野指数的比较,青光眼患者TOP程序和Normal程序检查MS分别为15.78±4.81,13.33±4.24,P=0.008;MD分别为13.36±4.89,14.31±4.18,P=0.02;LV分别为65.40±37.55,50.77±34.24,P<0.001;两种程序检查RF值均小于15%。③两种检查方法所费时间,TOP程序为4.10±0.59分Normal程序为11.01±3.15分。结论①TOP视野检查程序可大大地缩短检查时间,可用于大规模人群的筛查,但是TOP视野检查程序对早期青光眼检测敏感性偏低,仅为73%。②对中晚期病例,TOP程序与Normal程序相比较,MS高于正常阈值程序检查的结果,MD和LV低于正常阈值程序检查结果,也就是TOP视野检查程序的发现的视野缺损较小,暗点更浅。     

晚期青光眼患者视野检查的可靠性分析

目的本文探讨晚期青光眼与早中期青光眼患者视野检测的可靠性是否存在显著性差异。方法以2002年4月至2003年12月随诊于我科的临床确诊为青光眼的患者作为研究对象,应用OCTOPUS101型视野计中G2/TOP程序对双眼进行视野检测。以每位患者有一次以上视野检查经历及裸眼视力≥0.5,瞳孔直径大于2.5mm作为入选标准。共157只眼(90位患者)入选;年龄25岁到79岁,男性29人、女性61人。结果以平均缺损指数(MD,meandefect)分组:MD≥15dB为晚期青光眼组;MD<15dB为早中期青光眼组。MD≥15dB组RF值35.73±3.69,显著高于MD<15dB组5.14±0.73(P<0.01);根据RF值进行分组:RF>15%为RF异常组;RF≤15%为RF正常组,RF异常组的MD值8.64±1.08显著高于RF正常组4.38±0.38(P<0.01)。晚期青光眼组患者假阴性率远高于早中期青光眼组。结论晚期青光眼患者视野检查的可靠性因子(RF)与早中期患者相比有显著差异,在视野损伤严重的患者,高RF值并不一定代表患者视野检查的可靠性差,相反,当青光眼损伤到一定程度,RF值随之增大,可能与损伤程度有关。高RF值来源于高的假阴性率,青光眼的加重导致假阴性率的增高。     

单侧青光眼视野缺损患者假阴性反应的眼间差异

目的 探讨单侧青光眼视野缺损患者电脑视野检查假阴性反应率的眼间差异及相关因素。方法 选取2000年1月～2002年10月在青岛大学医学院附属医院眼科视野检查室行Octopus101自动静态视野检查的单侧青光眼视野缺损患者66例进行研究；比较患者眼间视力、眼压、杯盘比、检查时间及假阴性反应率、假阳性反应率、平均偏差、平均光敏感度的差异，并分析假阴性反应率的相关因素。结果 视野缺损眼与视野正常眼的假阴性反应率(FN)差异显著，且与检查的先后顺序无关，而两眼在视力、眼压、瞳孔直径等方面无明显差异；视野缺损眼平均偏差(MD)与FN相关，在MD越高的眼，FN越高；而正常眼MD与FN无关。结论 假阴性反应率可能与视野缺损有关；用假阴性反应率作为可靠性指数来监测受检者的专心程度、注意力集中程度，是不合适的。     

慢性闭角型青光眼视野损害的特点

目的　为了了解早中期慢性闭角型青光眼 (chronicangleclosureglaucoma ,CACG)的静态视野损害特点。对象与方法　对象为MD≤ 15dB的慢性青光眼患者 81例 81只眼 ,其中CACG 2 7例 2 7只眼 ,正常眼压性青光眼 19例 19只眼 ,和原发性开角型青光眼 3 5例 3 5只眼。采用Octopus10 1视野计G2程序 ,将视野内 5 9个静点划分为 9个区和中央 1个点 ,通过图中各点的值 ,分别计算每只眼的每个点、区的MD ;再将视野以 0°～ 180°为界 ,分成上下两个半侧视野 ,分别计算和比较上方和下方半侧视野的MD和LV ;最后对中央 9个点 (6°范围 )进行受累情况的判断 ,并进行CACG、POAG和NTG三组组内和组间的比较。结果　CACG组的中央区MD比POAG NTG组要小 (Z =-2 0 69,P =0 0 3 9) ,其余各区和中心点差异无显著性 (Z =-0 0 6～ 1 72 1,P =0 0 9～ 0 95 2 ) ;CACG和POAG上方半侧视野的MD明显比下方的MD要大 (P =0 0 2 4和 0 0 10 ) ,而NTG的上下方视野MD差异无显著性 (P =0 0 77)。CACG、NTG和POAG中央 6°视野的受累率分别是 2 5 9%、5 7 9%和 5 1 9% (P =0 0 40 )。结论　CACG上方半侧视野比下方受损明显 ,与POAG/NTG视野改变模式有所不同的是 ,中央视野比较不易受损。     

Multifocal objective perimetry in the detection of glaucomatous field loss.

PURPOSE: To test the ability of a new type of multifocal objective perimetry to identify glaucomatous visual field defects. METHODS: A multichannel visual evoked potential was recorded using the ObjectiVision Accumap perimeter. One hundred patients (age, 62.2 +/- 9.8 years, mean MD -6.5 +/- 4.17 dB) with open-angle glaucoma and confirmed glaucomatous visual field defects were tested and compared with the normal database of 100 normal subjects (age, 58.9 +/- 10.7 years). Both eyes were tested, but for determining sensitivity the eye with the lesser field defect was chosen if both qualified. The amplitude and intereye asymmetry coefficient for each zone of the field were calculated. A mean amplitude and multifocal objective perimetry severity index was calculated for each subject. RESULTS: In 95 of 100 (95%) patients with glaucoma Humphrey field defects were correlated with visual evoked potential amplitude reductions identifying a cluster of three or more abnormal zones. In two of five remaining patients with glaucoma the defect was detected on the intereye asymmetry analysis. Topographic location was well correlated with Humphrey fields. Mean amplitude was significantly reduced in 86 of the glaucoma cases (86%). The glaucoma severity index was abnormal in 93 glaucoma cases and showed a correlation with Humphrey MD (r = 0.67 right eyes, 0.69 left eyes). In 37 glaucoma cases with no scotoma by definition in the fellow eye, 22 (59.4%) had an abnormal multifocal objective perimetry, whereas only eight had some other aspect of their Humphrey visual field flagged as abnormal. CONCLUSIONS: Multifocal objective perimetry can assess the visual field and identify glaucomatous visual field defects. It may have the potential for identifying defects earlier than conventional perimetry.     

Structure and function evaluation (SAFE): II. Comparison of optic disk and visual field characteristics

PURPOSE: To evaluate the relationship between glaucomatous structural damage to the optic nerve and development of visual field loss with standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP). DESIGN: Cohort study. METHODS: Patients with elevated intraocular pressure and normal SAP visual fields were enrolled in this prospective study. Stereo optic disk photographs, SAP, and SWAP visual fields were obtained annually over a period of 4 or more years. Trained readers evaluated baseline and follow-up optic disk photographs for evidence of glaucomatous damage. Standard automated perimetry and SWAP examinations were evaluated according to previously validated criteria for development of confirmed visual field changes. RESULTS: Two-hundred ninety-five subjects (479 eyes) were enrolled. Following masked assessment of stereo photographs by an optic disk reading center, 272 of the 479 eyes were judged to have glaucomatous optic neuropathy at the time of study entry. Depending on the criteria employed, approximately 10% to 17.5% of all eyes developed confirmed visual field loss for SAP (conversions). Of the conversions, 75% to 80% had baseline glaucomatous optic disk damage, whereas normal and glaucomatous optic disks were equally divided (50%) among the nonconversion eyes. This difference was statistically significant (P <.003). Depending on the criteria employed, 4% to 12% of the eyes had confirmed SWAP deficits at baseline, and 4% to 8% developed confirmed SWAP defects at a follow-up examination. There was a greater percentage of eyes with a glaucomatous optic neuropathy in the group with SWAP deficits (75%-100%) than for those eyes in which SWAP remained normal (45%-60%). Some of these differences were statistically significant (P <.05). CONCLUSIONS: A strong relationship exists between glaucomatous optic disk damage at study entry and the subsequent development of a confirmed glaucomatous SAP visual field defect. A higher percentage of glaucomatous optic disks were also found in patients with SWAP deficits at baseline and in those who later developed SWAP deficits. These findings support the premise that a glaucomatous optic disk is predictive of the subsequent development of glaucomatous visual field loss.     

Use of Fieldmaster automated perimeter for the detection of early visual field changes in glaucoma

The efficacy of automated suprathreshold perimetry with Fieldmaster automated perimeter (model 101 PR and 200) was evaluated in the screening for very early glaucomatous visual field defects which failed to be detected with kinetic perimetry using a Goldmann perimeter. Evaluation of 117 eyes with elevated intraocular pressure revealed a small, relative defect in the central field in 14 eyes which was confirmed by static perimetry with a Tübinger perimeter. Although Fieldmaster model 200 is equipped with more target positions than model 101 PR, detectability of early defects was almost identical between two models. Automated suprathreshold perimetry with either model of Fieldmaster perimeter is useful in detecting the early changes which may be missed by kinetic perimetry with a Goldmann perimeter. Based on the difference in the false positive rate (45.6% with model 200 vs 26.7% with model 101 PR) the screening with 101 PR seems to be more rewarding.     

Relationship between parapapillary atrophy and visual field abnormality in primary open-angle glaucoma

PURPOSE: To investigate the relationship of parapapillary atrophy measured by confocal scanning laser ophthalmoscopy to visual field sensitivity measured with standard automated perimetry and short-wavelength automated perimetry in patients with primary open-angle glaucoma. METHODS: Forty-seven eyes of 47 primary open-angle glaucoma patients with increased intraocular pressure (> or = 22 mm Hg) were enrolled. Optic nerve head topography and parapapillary atrophy (beta and alpha zones) were assessed by confocal scanning laser ophthalmoscopy. Mean deviation and corrected pattern SD were assessed with standard automated perimetry and short-wavelength automated perimetry. RESULTS: Beta and alpha zones were found in 23 (49%) and 47 (100%) eyes with primary open-angle glaucoma, respectively. The area of beta zone showed significant correlations with MD of standard automated perimetry, corrected pattern SD of standard automated perimetry, and corrected pattern SD of short-wavelength automated perimetry (Spearman r = -0.366, P = .012; r = 0.327, P = .025; and r = 0.436, P = .002, respectively). The area of alpha zone showed a significant correlation with mean deviation of standard automated perimetry (r = -0.378, P = .009). Mean MD of standard automated perimetry, mean corrected pattern SD of standard automated perimetry, and mean corrected pattern SD of short-wavelength automated perimetry were significantly worse in eyes with beta zone than in eyes without beta zone. CONCLUSIONS: Parapapillary atrophy measured by confocal scanning laser ophthalmoscopy, especially beta zone, is associated with glaucomatous visual field loss demonstrated by standard automated perimetry and short-wavelength automated perimetry.     

Glaucomatous damage patterns by short-wavelength automated perimetry (SWAP) in glaucoma suspects

PURPOSE: To determine the glaucomatous visual field damage patterns by short-wavelength automated perimetry (SWAP) in glaucoma suspects, and to compare the frequency of diffuse visual field losses and localized defects. METHODS: 157 eyes of 157 ocular hypertensive subjects who met the selection criteria (intraocular pressure greater than 21 mm Hg and normal standard visual fields) were studied. SWAP was done with a modified Humphrey Field Analyzer. Total (TD) and Pattern Deviation (PD) probability maps were calculated for SWAP. The frequency of abnormlities in the TD and PD were determined, analyzing the visual field loss components. RESULTS: The involvement of the test points was more frequent on the TD plots than on the PD plots for all levels of defects (p< 0.001). The glaucomatous defects also showed certain topographical distribution. CONCLUSIONS: A diffuse sensitivity component of visual field loss was found at all SWAP defect depths in glaucoma suspects.     

Pattern electroretinogram recorded by skin electrodes in early ocular hypertension and glaucoma

Diagnostic value of transient pattern electroretinogram (PERG), recorded by skin electrodes, was compared with Goldmann perimetry in cases of ocular hypertension and glaucoma. According to the assumption that the PERG mostly reflects activity of the retinal glanglion cells, and histological evidence that 30–50% atrophy of the retinal ganglion cells is necessary to cause defects in visual field, we wanted to assess if i) this method could be more sensitive in detecting early glaucomatous damage than routine Goldmann perimetry in eyes with normal or only borderline elevated intraocular pressure in the time of PERG recording (first group of patients), and ii) how the PERG amplitude corresponds to ganglion cell loss, expected in the eyes with already detectable initial glaucomatous visual field defects, according to Goldmann II/2 isopter, with normal or borderline elevated intraocular pressure in the time of PERG recording (second group).In the group with no visual field defects subnormal amplitude of the major positive component of the PERG, N1-P1, was detected in three of 30 eyes (10%), while in the group with initial visual field defects N1-P1 amplitude was subnormal in 6 of 11 eyes (54%).The amplitude of the major negative PERG component, P1-N2, was found normal in all eyes of the first group and subnormal in 5 eyes (45%) of the second group.Abbreviations PERG pattern electroretinogram - VFD visual field defect - IOP intraocular pressure     

Predictive value of short-wavelength automated perimetry: a 3-year follow-up study

PURPOSE: To determine whether structural changes in the retinal nerve fiber layer (RNFL) and functional abnormalities in short-wavelength automated perimetry (SWAP) can predict the onset of functional losses in standard automated perimetry patients suspected of having glaucoma. DESIGN: Prospective observational case series. PARTICIPANTS: A total of 160 eyes of ocular hypertensive subjects (intraocular pressure greater than 21 mmHg and normal standard automated perimetry) were included in the study. INTERVENTIONS: The subjects underwent RNFL photographic evaluation and SWAP. Standard automated perimetries were repeated after 3 years to evaluate glaucomatous losses. MAIN OUTCOME MEASURES: Onset of glaucomatous defects in conventional automated perimetry after 3 years of follow-up, with or without prior glaucomatous defects in RNFL and SWAP. RESULTS: At the beginning of the study, 77 eyes showed RNFL losses (48%), and 58 eyes showed abnormalities in SWAP (36%). After the 3-year follow-up period, 14 of 77 eyes with RNFL losses had standard automated perimetry abnormalities (predicting sensitivity 93%), whereas 11 of 58 eyes with abnormal SWAP had standard automated perimetry losses (73% sensitivity). CONCLUSIONS: RNFL and SWAP losses are signs of early glaucomatous damage and can predict functional losses in standard automated perimetry.     

Flicker perimetry (CFF) in glaucoma diagnosis

PURPOSE: Evaluation of CFF perimetry results in patients with suspected glaucoma. MATERIAL AND METHODS: Visual field was measured on Octopus 301 perimeter with option "flicker perimetry". 49 patients (98 eyes) with suspected glaucoma were tested. Standard W/W perimetry revealed glaucomatous visual field defect in one eye, but not in the second eye. Patients with cataract and diabetes were not taken into consideration. RESULTS: Defects in CFF perimetry tests were found in 71.4% of cases, but in W/W perimetry test in 50.0% of cases. CONCLUSIONS: Perimetry CFF is useful for early detection and follow up of glaucoma. Indices MD and LV may be used for those purposes.     

Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma

PURPOSE: To compare short-wavelength automated perimetry, frequency-doubling technology perimetry, and motion-automated perimetry, each of which assesses different aspects of visual function, in eyes with glaucomatous optic neuropathy and ocular hypertension. METHODS: One hundred thirty-six eyes from 136 subjects were evaluated with all three tests as well as with standard automated perimetry. Fields were not used in the classification of study groups to prevent bias, because the major purpose of the study was to evaluate each field type relative to the others. Seventy-one of the 136 eyes had glaucomatous optic neuropathy, 37 had ocular hypertension, and 28 served as age-matched normal control eyes. Glaucomatous optic neuropathy was defined by assessment of stereophotographs. Criteria were asymmetrical cupping, the presence of rim thinning, notching, excavation, or nerve fiber layer defect. Ocular hypertensive eyes had intraocular pressure of 23 mm Hg or more on at least two occasions and normal-appearing optic disc stereophotographs. Criteria for abnormality on each visual field test were selected to approximate a specificity of 90% in the normal eyes. Thresholds for each of the four tests were compared, to determine the percentage that were abnormal within each patient group and to assess the agreement among test results for abnormality, location, and extent of visual field deficit. RESULTS: Each test identified a subset of the eyes with glaucomatous optic neuropathy as abnormal: 46% with standard perimetry, 61% with short-wavelength automated perimetry, 70% with frequency-doubling perimetry, and 52% with motion-automated perimetry. In the ocular hypertensive eyes, standard perimetry was abnormal in 5%, short wavelength in 22%, frequency doubling in 46%, and motion in 30%. Fifty-four percent (38/71) of eyes with glaucomatous optic neuropathy were normal on standard fields. However, 90% were identified by at least one of the specific visual function tests. Combining tests improved sensitivity with slight reductions in specificity. The agreement in at least one quadrant, when a defect was present with more than one test, was very high at 92% to 97%. More extensive deficits were shown by frequency-doubling perimetry followed by short-wavelength automated perimetry, then motion-automated perimetry, and last, standard perimetry. However, there were significant individual differences in which test of any given pairing was more extensively affected. Only 30% (11/37) of the ocular hypertensive eyes showed no deficits at all compared with 71% (20/28) of the control eyes (P < 0.001). CONCLUSIONS: For detection of functional loss standard visual field testing is not optimum; a combination of two or more tests may improve detection of functional loss in these eyes; in an individual, the same retinal location is damaged, regardless of visual function under test; glaucomatous optic neuropathy identified on stereophotographs may precede currently measurable function loss in some eyes; conversely, function loss with specific tests may precede detection of abnormality by stereophotograph review; and short-wavelength automated perimetry, frequency-doubling perimetry, and motion-automated perimetry continue to show promise as early indicators of function loss in glaucoma.     

Is visual field evaluation using multiple correlations and linear regressions useful? An evaluation of Delphi perimetry

· Background: Delphi perimetry is a method of visual field examination which produces a statistical estimation of the visual field by testing only four critical points of the central visual field. This study was performed to evaluate this technique for the detection of glaucomatous field loss. · Method: Patients with glaucoma and ocular hypertension underwent Delphi perimetry and Humphrey visual field analysis (HVFA) program 24-2. The visual field results of both examination were compared. · Results: Of 262 eyes from 199 patients, 120 eyes showed glaucomatous defects by HVFA and 142 were normal. Delphi perimetry showed abnormal visual fields in 107 eyes, 13 of which were false-positive results as Humphrey visual fields were normal. Delphi classified 155 fields as normal, of which 26 were false negatives as Humphrey visual fields showed glaucomatous defects. Therefore, the sensitivity of Delphi perimetry for the detection of glaucomatous visual field defect was 78% and the specificity was 91%. In the 26 false-negative eyes, the most common defect missed was an isolated paracentral scotoma or an early nasal step. Furthermore, 27 of the 94 glaucomatous eyes classified as abnormal by Delphi had defects estimated by Delphi perimetry that corresponded poorly to the field loss demonstrated by Humphrey visual field analysis. Therefore, qualitative sensitivity and specificity of Delphi perimetry for producing an accurate representation of the location, extent and defect depth of glaucomatous visual field loss would be 48.8% and 72% respectively. · Conclusion: In this study Delphi perimetry failed to give an accurate statistical estimation of the visual field in an unacceptably high number of cases; therefore, it cannot be recommended for clinical use. Received: 12 June 1997 Revised version received: 11 November 1997 Accepted: 13 November 1997