Computer perimetry in the diagnosis of primary open-angle glaucoma

Static perimetry, made using Humphrey and Octopus expert class perimeters, is called the standard automated perimetry (SAP); and for more than 30 years, it is the “gold standard” in assessing the visual field in glaucoma diagnosis. Currently, many computer perimeters appeared on the Russian market. The article reviews modern methods of computerized perimetry which are most widespread in our country and presents their comparative characteristics. (For citation: Serdyukova SA, Simakova IL. Computer perimetry in the diagnosis of primary open-angle glaucoma. Ophthalmology Journal. 2018;11(1):54-65. doi: 10.17816/OV11154-65).

VISUAL FIELD DEFECTS;

Objectives: To obtain and compare the exact visual status before and afterexcision of sella supra sellar tumors using the computerized perimetry as a standard measuringtools and then compare with the international studies. Background: Sella suprasellar tumorsare though not so common but affect visual acuity of patients and their quality of life drops.These tumors include pituitary adenoma commonest in the adult population, meningioma,Craniopharyngioma, astrocytic glioma, Optic nerve Glioma, Germinoma, Dermoid, Pituitarymetastases. We planned a descriptive case series study to compare the pre and post excisionvisual field defects using computerized perimetry. Study Design: Case series study. Setting:Department of Neurosurgery, Pakistan Institute of Medical Sciences, SZABMU, and Islamabad.Period: 2 years from January 2015 to December 2016. Methods: A total of 73 patients withsella suprasellar tumors were identified and enrolled. Patients between the age of 10 and55 years were selected on the basis of having sella supra sellar tumor on CT/MRI brain withcontrast. Patients whose age was less than 10 years and more than 55 years were excluded.Moreover, patients with post radiation necrosis diagnosed on MRI and MR spectroscopy brain,those operated for other eye pathology and patients with sella supra sellar SOL having comorbiditieslike diabetes mellitus, hypertension etc. were also excluded from the study. Thestudy outcome was measured in terms of comparison of visual field defects after excision ofsella suprasellar tumors using computerized perimetry. Results: The average age of patientswas 42.1 + 6.8 years ranging from 10 to 55 years. Female gender was predominant; therewere 40 (54.8%) female patients. The mean computerized perimetry was 0.65 + 0.34 LogMARbefore surgery which improved to 0.19 + 0.12 LogMAR after surgery. Overall, of the 73 cases,63 (86.4%) had improvement whereas 10 (13.6%) study cases had no improvement in thevisual field on follow-up. Conclusion: It can be concluded that after craniotomy and excisionof sella suprasellar tumors, perimetry showed improvement in the majority of the study cases.

Some aspects of the comparative characteristics of different computerized perimetry methods

Purpose - to compare the ease of use, the comfort for persons to be tested, the examination rate, as well as the variability of repeated results obtained using four methods of computerized perimetry. Materials and methods. This clinical study included three groups of patients with open-angle glaucoma (OAG). The 1st group included patients with OAG stage I, the 2nd group - with OAG stage II, the 3rd group - with OAG stage III. The control group included healthy individuals. All tested persons underwent examinations by 4 computerized methods (HFA II, Tomey AP-1000, Pericom, and the FDT-perimetry modification developed at the Ophthalmology Department of the Military Medical Academy). Results. FDT-perimetry appeared to be the shortest, easiest test and most comfortable for tested persons. Perimetry using Tomey AP-1000, Pericom and HFA II was more time-consuming and more difficult to perform. Repeated results of all four methods were better than the first one due to the “learning curve” effect, and showed different variability. Conclusion. To obtain reliable computerized perimetry results, taking into account the possible “learning curve” effect, we recommend repeating the perimetric test at least 2-3 times at same conditions. It is important for the selected perimetric test to be easy to perform, comfortable for persons to be tested, and quite fast to perform.