M. Sánchez Méndez

Combined spatial, contrast, and temporal functions perimetry in mild glaucoma and ocular hypertension

PURPOSE To evaluate the diagnostic ability of a new perimetric procedure in glaucoma. METHODS Pulsar perimeter shows white circular sinusoidal grating patterns with decreasing amplitude, 5 in diameter, 500 msec in duration in 66 locations. The stimuli scale combines spatial resolution and contrast. The stimuli were shown with centrifugal wave motion at 8 cyl/deg (K6W) or pulse at 30 Hz (T30W). Fifty-six normal eyes and 82 eyes with ocular hypertension and mild glaucoma were included. These 82 cases were classified into four levels of diagnostic certainty, from 0 (ocular hypertension) to 3 (mild glaucoma). RESULTS Mean examination time was 3:49 min. Specificity was 96.4% (T30W) and 94.6% (K6W). Sensitivities for levels 0 and 3 were 34.5% to 100% (T30W) and 24.1% to 75% (K6W). The receiver operating characteristic (ROC) curve areas for T30W at levels 1, 2, and 3 were 0.88, 0.94, and 0.99. The ROC areas for K6W were 0.83, 0.91, and 0.97. There was good correlation between both Pulsar perimetries (r=0.88), but it was lower with conventional perimetry (r=0.58 for T30W and r=0.59 for K6W). CONCLUSIONS The novel Pulsar T30W perimetry may be helpful for the study of mild glaucoma and ocular hypertension. (Eur J Ophthalmol 2004; 14: 514-22).

Comparación del rango de medida de defectos entre la perimetría estándar blanco/blanco y la perimetría Pulsar

OBJECTIVES Normal thresholds on Pulsar perimetry fall faster than those of standard perimetry in the peripheral visual field. Two related studies were performed. Firstly, the frequency distributions of glaucoma defects on standard automated perimetry (SAP) and the relationship of the centre and periphery (Study A) were studied first, followed by an attempt to establish the limits of pulsar perimetry (Study B). MATERIAL AND METHOD A: frequency of defects was calculated in 78.663 SAP perimetries (G1-TOP, Octopus 1-2-3, Haag-Streit). Study B: 204 eyes with mean defect (MD-SAP) lower than 9 dB were examined 8.92 ± 4.19 times with SAP (TOP-32, Octopus 311) and temporal modulation perimetry (T30W, Pulsar Perimeter, Haag-Streit). RESULTS Study A: 50.7% of the SAP examinations showed MD values lower than 9 dB and 32.7% bellow 6 dB. The MD correlation of the central 20° with the MD of the most peripheral points was r=0.933. Study B: in cases with MD-TOP-32 lower than 6 dB, SAP had the maximum possibility of detecting defect in 0.02% of points and Pulsar in 0.29%. In subjects with MD-TOP-32 between 6 and 9 dB frequencies were 0.38% in SAP and 3.5% in Pulsar (5.1% for eccentricities higher than 20°). CONCLUSIONS Pulsar allows detecting defects, without range limitations, in the initial half of SAP frequencies expected on glaucoma patients. In order to study the progression of deeper defects the examination should focus on the central points, where the dynamic range of both systems is more equivalent.

Comparing the ranges of defect measured with standard white on white and Pulsar perimetries

Abstract Objectives Normal thresholds on Pulsar perimetry fall faster than those of standard perimetry in the peripheral visual field. Two related studies were performed. Firstly, the frequency distributions of glaucoma defects on standard automated perimetry (SAP) and the relationship of the centre and periphery (Study A) were studied first, followed by an attempt to establish the limits of pulsar perimetry (Study B). Material and method A: frequency of defects was calculated in 78.663 SAP perimetries (G1-TOP, Octopus 1-2-3, Haag-Streit). Study B: 204 eyes with mean defect (MD-SAP) lower than 9 dB were examined 8.92±4.19 times with SAP (TOP-32, Octopus 311) and temporal modulation perimetry (T30W, Pulsar Perimeter, Haag-Streit). Results Study A: 50.7% of the SAP examinations showed MD values lower than 9 dB and 32.7% bellow 6 dB. The MD correlation of the central 20° with the MD of the most peripheral points was r=0.933. Study B: in cases with MD-TOP-32 lower than 6 dB, SAP had the maximum possibility of detecting defect in 0.02% of points and Pulsar in 0.29%. In subjects with MD-TOP-32 between 6 and 9 dB frequencies were 0.38% in SAP and 3.5% in Pulsar (5.1% for eccentricities higher than 20°). Conclusions Pulsar allows detecting defects, without range limitations, in the initial half of SAP frequencies expected on glaucoma patients. In order to study the progression of deeper defects the examination should focus on the central points, where the dynamic range of both systems is more equivalent.

Is oculokinetic perimetry useful

An evaluation was carried out comparing Oculokinetic Perimetry (O. K. P.) with Automatic Perimetry of Thresholds (Hipocampus Perimeter) for ocular hypertension and glaucoma studying 145 eyes. The O.K.P. shows a sensitivity between 35.65 and 38.54%, a specificity of 76.67–79.59%, a + predictive value of 78.72–85.42%, and a — predictive value of 23.71–39.80%.An evaluation was carried out comparing Oculokinetic Perimetry (O. K. P.) with Automatic Perimetry of Thresholds (Hipocampus Perimeter) for ocular hypertension and glaucoma studying 145 eyes. The O.K.P. shows a sensitivity between 35.65 and 38.54%, a specificity of 76.67–79.59%, a + predictive value of 78.72–85.42%, and a — predictive value of 23.71–39.80%.