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An Alternative to Standard Perimetry in Patients With Neuro-ophthalmic Disease and Glaucoma

Stacy L. Pineles, MD; Nicholas J. Volpe, MD; Eydie Miller-Ellis, MD; Steven L. Galetta, MD; Prithvi S. Sankar, MD; Kenneth S. Shindler, MD, PhD; Maureen G. Maguire, PhD

Arch Ophthalmol. 2006;124:363-369.

Objectives  To create a fully automated, combined perimetry program consisting of a static examination and a kinetic examination, and to compare the results of this test with standard static and kinetic visual fields (VFs).

Methods  Fifty-six patients (74 eyes) undergoing neuro-ophthalmic or glaucoma evaluation who had standard static or kinetic perimetry examinations underwent the combined perimetry test. This automated, combined test, performed on the Octopus 101 perimeter, consisted of a static tendency-oriented perimetry examination and a preprogrammed kinetic examination. Three masked physician reviewers independently classified all of the VFs. The VF pairs were considered a match if the consensus descriptions of the standard and combined VFs matched.

Results  Thirty-seven eyes underwent evaluation for neuro-ophthalmic disease (comparison standard test, 20 static and 17 kinetic) and 37 for glaucoma (comparison standard test, 17 static and 20 kinetic). The VP pairs matched in 32 eyes (86%) in the neuro-ophthalmic group and 28 (76%) in the glaucoma group. On inspection by a fourth reviewer, many of the nonmatching VF pairs were those for which a consensus was not reached, but still conveyed similar information. Two glaucomatous eyes demonstrated central scotomata not delineated by the combined examination findings. Two subtle nasal steps were detected solely by the combined examination. The combined test ranged in time from 6 to 12 minutes per eye.

Conclusions  The Octopus 101 perimeter can be used to create an automated test that combines the advantages of static and kinetic perimetry and produces equivalent results while not requiring examiner expertise.

Author Affiliations: Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia.

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