| 1. |
- Airaksinen, P J, et al.
(författare)
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Visual field and retinal nerve fibre layer in early glaucoma after optic disc haemorrhage
- 1983
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Ingår i: Acta Ophthalmologica. - : Wiley. - 0001-639X .- 1755-375X. ; 61:2, s. 94-186
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Tidskriftsartikel (refereegranskat)abstract
- Computerized visual field testing with the Competer automatic perimeter including automatic profile perimetry revealed early glaucomatous field loss in 9 of 10 eyes with photographically demonstrable retinal nerve fibre layer (RNFL) defects after optic disc haemorrhages despite the fact than conventional routine perimetry had failed to do so. In 7 of these cases the Competer central pattern test was abnormal; in 2 cases field defects could be shown only when automatic high-resolution static profile perimetry was performed and directed according to the information present in wide-angle RNFL photographs. A field defect was also found in one of five eyes with no photographic RNFL changes. Visual field defects seem to occur in a higher proportion of cases with RNFL defects than was previously thought, but they can be very subtle and hard to find. There are, however, cases where in spite of the presence of an indisputable RNFL defect no visual field defects can be shown even with painstaking technique and conversely field defects may be present without RNFL defects. Automatic perimetry and RNFL photography complement each other in early detection and quantitation of glaucomatous damage.
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| 2. |
- Asman, P, et al.
(författare)
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Evaluation of adaptive spatial enhancement in suprathreshold visual field screening
- 1988
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Ingår i: Ophthalmology. - 0161-6420. ; 95:12, s. 62-1656
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Tidskriftsartikel (refereegranskat)abstract
- Sixty-three normal subjects and 94 abnormal patients, most of whom had glaucoma, were tested in the central visual field using a threshold-related, eccentricity-compensated, spatially adaptive suprathreshold screening program and a full-threshold program on the Humphrey field analyzer. The initial stimulus locations on the screening test were identical to those of the threshold test; additional screening stimuli were presented surrounding each missed initial stimulus. Surprisingly, this spatial enhancement strategy did not improve sensitivity or specificity rates of the screening beyond that achieved by considering the initial stimulus locations alone. Points missed during screening often showed a depressed sensitivity rate (measured threshold greater than 6 dB below the age-corrected normal reference value) in the same area of the threshold field. This was true in fields from abnormal and normal subjects. This finding of persistent shallow defects in the same test session among otherwise normal persons has disturbing implications for the importance of "confirmed" defects in the diagnosis of disease.
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| 3. |
- Dyster-Aas, K, et al.
(författare)
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Computerized visual field screening in the management of patients with ocular hypertension
- 1980
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Ingår i: Acta Ophthalmologica. - : Wiley. - 0001-639X .- 1755-375X. ; 58:6, s. 918-928
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Tidskriftsartikel (refereegranskat)abstract
- Visual field testing which the Computer fully automatic computerized perimeter (Heijl & Krakau 1975) employing a supra-liminal screening test procedure was used in a material of 1013 eyes with ocular hypertension in which earlier routine perimetry (kinetic and static) on the Goldmann perimeter had yielded a normal result. The automatic screening was repeated if positive, and manual control perimetry was used in order to confirm or reject identified field defects. This procedure revealed field defects that could be confirmed at both automatic and manual perimetry in 3.6% of the eyes. In the control group the incidence of field defects found at manual perimetry during the same time interval was calculated at 0.4%. Thus automatic screening revealed several times more field defects than manual routine perimetry. Eyes in which repeated automatic screening had indicated defects which manual control perimetry failed to confirm, showed a high percentage of field loss at later follow-up. The results are discussed, and the conclusion is drawn that automatic screening is clearly superior to manual routine perimetry used at present. The most practical solution in many eye departments would be to use a computerized perimeter for the visual field screening of glaucoma suspects.
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| 4. |
- Heijl, A, et al.
(författare)
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A clinical study of perimetric probability maps
- 1989
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Ingår i: Archives of Ophthalmology. - : American Medical Association (AMA). - 0003-9950. ; 107:2, s. 199-203
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Tidskriftsartikel (refereegranskat)abstract
- Perimetric probability maps depict visual field results in terms of the frequency with which the measured findings are seen in a normal population. We tested clinically the importance of the model of the normal visual field used to calculate such maps. Forty-one eyes of 41 normal subjects and 58 eyes of 46 glaucomatous patients were studied. Probability maps were calculated by means of two different models of the normal visual field. The first model assumed gaussian threshold distributions with constant variability across the field. The second used empirically determined nongaussian location-dependent threshold distributions. Probability maps using the empiric model allowed better separation between glaucomatous and normal eyes, and the number of significant points in normal subjects was in better agreement with the theoretically expected number. The gaussian model yielded an unacceptably high frequency of significant points in normal fields, particularly in the midperiphery. The clinical usefulness of perimetric probability maps depends critically on the choice of normal visual field model.
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| 5. |
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| 6. |
- Heijl, A
(författare)
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Computerized perimetry in glaucoma management
- 1989
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Ingår i: Acta Ophthalmologica. - : Wiley. - 0001-639X .- 1755-375X. ; 67:1, s. 1-12
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Forskningsöversikt (refereegranskat)abstract
- The present article discusses the role of computerized perimetry in the management of patients with suspect and manifest glaucoma. The value of visual field examination is compared to that of inspection and photography of the optic disc and to some extent to retinal nerve fibre layer photography. Computerized perimetry is related to standard manual visual field examination. Guidelines are offered for the choice of test programs and for the interpretation of results.
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| 7. |
- Heijl, A, et al.
(författare)
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Computerized profile perimetry in glaucoma
- 1980
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Ingår i: Archives of Ophthalmology. - 0003-9950. ; 98:12, s. 201-2199
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Tidskriftsartikel (refereegranskat)abstract
- The new profile testing mode of the COMPETER automatic perimeter was clinically tested and compared with careful manual profile perimetry on the Tübinger perimeter. Each of 110 patients with glaucomatous field defects, patients with suspected glaucoma, and normal subjects had one meridian tested. All of the 55 patients who showed an abnormal result on the manual profile also had abnormal findings on the automatic test. Two (4%) of the profiles labeled as normal on initial manual perimetry were identified by the automatic perimeter to be abnormal, and these defects were confirmed on repeated manual profile perimetry. The automatic perimetry gave five (9%) false-positive results in the 53 normal manual profiles, thus giving a specificity of 91%. In two of these cases, the automatic profile indicated defects in areas where the manual profile appeared normal, but there was abnormality in the manual kinetic perimetry in the affected area. The automatic profiles of the COMPETER automatic perimeter are accurate, sensitive, time-saving, and clinically useful.
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| 8. |
- Heijl, A, et al.
(författare)
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Diagnosis of early glaucoma with flicker comparisons of serial disc photographs
- 1989
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Ingår i: Investigative Ophthalmology & Visual Science. - 0146-0404. ; 30:11, s. 84-2376
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated flicker comparison, a technique for detecting differences in serial fundus photographs. Serial optic disc photographs and computerized threshold visual fields were obtained every 3 months for an average of 40 months in 131 eyes of 81 patients with elevated intraocular pressure and normal visual fields. Two serial monophotographs were projected, optically aligned, and superimposed; analysis was done by alternately viewing first one and then the other image. We found flicker analysis of serial disc photographs to provide results which were closely correlated with those of computerized threshold perimetry. Thus, of those 12 eyes which developed field defects, eight showed definite change and two showed highly suspected change in optic disc configuration. Only two eyes showed a definite alteration in optic disc anatomy without the development of field loss, and field defects appeared in only one of 109 eyes in which there was no change or suspected change on flicker comparison. The flicker method was more sensitive than conventional nonflickered comparisons, but changes could usually be seen also with conventional inspection once they had been detected by the flicker method. Our findings suggest that flicker analysis may offer a considerable improvement over current standard methods of analyzing serial photography and may be a useful complement to routine perimetry. However, this method requires special equipment; requires that the photographs be similarly centered; and is time-consuming. Alignment of photographs by means of computerized image analysis techniques could make the method clinically practicable.
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| 9. |
- Heijl, A
(författare)
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Effect of IOP on the visual field in ocuLar hypertension and glaucoma
- 1989
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Ingår i: International Ophthalmology. - 0165-5701. ; 13:1-2, s. 24-119
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Tidskriftsartikel (refereegranskat)abstract
- The traditional opinion that increased intraocular pressure is the cause of glaucoma is controversial, probably mainly because of the fact that firm evidence for the value of pressure reduction is largely lacking. The present article reviews results from short term studies of visual fields before and after pressure reduction. It also reviews published and unpublished preliminary results from studies addressing the problem of whether the long term visual field prognosis, in glaucoma and in ocular hypertension, is affected by pressure lowering therapy. There is no convincing agreement among results from modern studies using computerized perimetry indicating that acute lowering of the ocular tension results in an improvement of the glaucomatous visual field. Long-term result are equally conflicting, and often negative. We have noted from a preliminary analysis of our own masked, prospective study of patients with 'high risk' ocular hypertension, that the same results may be interpreted in quite different ways. The results of available studies certainly indicate that pressure reduction does not automatically lead to clear and positive effects on the visual field. The studies have often been small, however, and have usually not had the power of detecting small effects of treatment. Also, pressure reduction has usually not been dramatic and many treated patients have maintained 'elevated' pressure levels. Patients with very high pressures have not been included, and the effect of pressure reduction in this situation has therefore not been investigated at all. More controlled, prospective therapeutic studies are necessary and ethical. It seems particularly important to study the long-term effects of non-pharmacologically induced pressure reduction in patients with manifest field loss.(ABSTRACT TRUNCATED AT 250 WORDS)
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| 10. |
- Heijl, A
(författare)
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Lack of diffuse loss of differential light sensitivity in early glaucoma
- 1989
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Ingår i: Acta Ophthalmologica. - : Wiley. - 0001-639X .- 1755-375X. ; 67:4, s. 60-353
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Tidskriftsartikel (refereegranskat)abstract
- We studied the differential light sensitivity in 83 patients who were prospectively followed with computerized threshold preimetry and optic disc pathography because of suspect glaucoma. Eyes with media opacities were excluded from the analysis. Fourteen eyes developed progressive optic disc cupping and/or localized visual field loss. In this glaucoma group light sensitivity in the 10 best points in the visual field did not deviate more from estimated age-corrected standard values than in the remaining groups of 115 eyes with increased intraocular pressure and 18 normotensive eyes. The results do not support the concept that diffuse loss of differential light sensitivity should be common in early glaucoma.
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