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Visual Field Testing (visual + field_testing)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Does the niqab (veil) wearer satisfy the minimal visual field for driving?

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2008
E. Ian Pearce
Abstract Visual field testing of subjects wearing a niqab was carried out using the approved (Esterman) test on a Humphrey perimeter to determine if visually normal subjects met the European driving standard. Measurement of aperture dimensions of the niqab when worn was recorded. When wearing the niqab, all subjects achieved a visual field adequate to satisfy UK/European driving standards. A measurement of the limiting aperture size was obtained and a self-test method for niqab wearers was determined. [source]

Combined intravitreal anti-vascular endothelial growth factor (Avastin®) and photodynamic therapy to treat retinal juxtapapillary capillary haemangioma

ACTA OPHTHALMOLOGICA, Issue 5 2010
Stefan Mennel
Abstract. Objective:, Retinal capillary haemangioma complications are characterized by progressive exudation with consecutive intraretinal and subretinal leakage. A successful therapy without side-effects has not been found. We report a case of retinal juxtapapillary capillary haemangioma causing consecutive leakage with macular involvement. The tumour was treated with a combination of anti-vascular endothelial growth factor (VEGF) and photodynamic therapy (PDT) and was followed for 1 year. Methods:, A 44-year-old woman with retinal juxtapapillary capillary haemangioma in the right eye experienced a decrease of visual acuity from 20/20 to 20/60 because of a severe leakage from the tumour involving the macula with lipid depositions. Two sessions of PDT (sparing the part of the haemangioma located within the optic disc) and five injections of bevacizumab were applied in a period of 5 months. Visual acuity, visual field testing, retinal thickness measurements, fundus photography and fluorescein angiography were performed to evaluate the treatment effect. Results:, One year after the last injection, visual acuity increased to 20/40. All lipid exudates at the posterior pole resolved. Retinal thickness decreased from 490 to 150 ,m with the restoration of normal central macular architecture. Leakage in fluorescence angiography reduced significantly, but hyperfluorescence of the tumour was still evident. Visual field testing and angiography did not show any treatment-related vaso-occlusive side-effects. Conclusion:, In this single case, the combination of anti-VEGF and PDT appeared to be an effective strategy for the treatment of retinal juxtapapillary capillary haemangioma without side-effects. Further studies with a greater number of eyes and adequate follow-up are necessary to support these first clinical results. [source]

Long-term review of driving potential following bilateral panretinal photocoagulation for proliferative diabetic retinopathy

DIABETIC MEDICINE, Issue 1 2009
S. A. Vernon
Abstract Aim To determine the necessity for repeated Driver and Vehicle Licensing Agency (DVLA) visual field testing in people with diabetes who have had bilateral panretinal photocoagulation (PRP) for proliferative diabetic retinopathy. Methods A questionnaire survey was conducted of driving history in a cohort of people with diabetes who had been treated with bilateral PRP for proliferative retinopathy between 1988 and 1990. In addition, all similarly eligible subjects attending the diabetic retinal review clinic over a 12-month period who had had laser between 1991 and 2000 were questioned as to their driving status. Results Forty-five surviving patients from the 1988,1990 cohort were eligible and 25 returned the questionnaire (55%). Eight had never driven and 15 (13 with Type 1 diabetes) still held a valid licence, having passed the DVLA field test on a number of occasions. Neither of the two patients who had stopped driving reported failing the DVLA field test as the reason for stopping. All 12 of the patients directly questioned in the clinic were still driving and had passed at least one repeat DVLA test. Conclusions People with Type 1 diabetes who have no further laser treatment for proliferative diabetic retinopathy can expect to retain their UK driving licence for at least 15 years following small-burn PRP, provided they maintain sufficient acuity. [source]

How good are we at advising appropriate patients with glaucoma to inform the DVLA?

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2008
A closed audit loop
Abstract Purpose:, To establish how good we are as clinicians at advising glaucoma patients with bilateral visual field defects of their legal responsibility to inform the Driver and Vehicle Licensing Agency (DVLA). By using a sticker placed in the patients' notes to highlight driving status and visual fields, we sought to improve our success in providing and documenting this advice. Methods:, We interviewed and examined the notes of two groups of 100 consecutive glaucoma patients before and after the introduction of a ,driver sticker' placed into patients' notes at the time of visual field testing. We examined the documentation of driving status, and the provision and documentation of advice regarding the DVLA. Results:, In the first audit, we found only 9% of patients had driving status documented. Only 20% of drivers with bilateral field defects were advised to inform the DVLA with 11.4% documentation of this advice. After the introduction of the sticker, we succeeded in improving the documentation of driving status to 99%. We advised and documented the advice to inform the DVLA in 97% of drivers with bilateral field defects. Conclusions:, We found that as a unit we were poor at documenting driving status and advising glaucoma patients with bilateral field defects to inform the DVLA. By the simple measure of introducing a sticker into patients' notes, we were able to highlight this critical group and improve our provision and documentation of appropriate advice regarding informing the DVLA. [source]

Vision screening of older people

OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 6 2007
Zahra Jessa
Abstract A recent systematic review found that between 20% and 50% of older people in the UK have undetected reduced vision and in most cases this is caused by refractive error or cataracts, and is correctable. Two approaches to improve the detection of these problems are to better publicise optometric services and to carry out community-based vision screening of older people. Screening programmes should pass the Wilson criteria and a consideration of these highlights three inter-related questions: ,Is vision screening effective at detecting correctable low vision in older people?'; ,Which tests should be included?' and ,Which venues are most appropriate?' We carried out a systematic review to investigate these questions. For the first question, only one study was found which met our selection criteria. The ,gold standard' eye examination in this study lacked several important components, and the vision screening method that was used was not found to be very effective. The review revealed other studies, which, although not meeting our selection criteria, included relevant information. The screening studies highlight the lack of agreement on the content of a gold standard eye examination and of the test(s) that should be used to screen vision. Visual function in older people is not adequately described by high contrast visual acuity (VA), nor by self-reports of visual difficulties. Other tests that may be relevant include visual field testing, low contrast VA, contrast sensitivity and stereo-acuity. The pinhole test has often been used in attempts to detect uncorrected refractive errors, but results from this test can be problematic and possible reasons for this are discussed. Appropriate venues for vision screening are contingent upon the format of the vision screening programme. There is still uncertainty over the battery of vision tests that are most appropriate. This, and optimum venues for screening, require further research before it can be fully determined whether vision screening of older people meets the Wilson criteria. If a vision screening programme using a battery of vision tests, perhaps computerised, can be established, then this should be tested to determine the sensitivity and specificity for detecting the target conditions. Ultimately, longitudinal studies are necessary to determine whether such a screening programme will lead to improved visual performance and quality of life in older people. [source]

4222: Potential retinal causes: when and how to investigate

ACTA OPHTHALMOLOGICA, Issue 2010
BP LEROY
Purpose To describe the retinal conditions that need to be excluded when non-organic visual loss is suspected, and the investigations required to either confirm or exclude them. Methods A case presentation format will be used to illustrate those conditions which can be discovered using psychophysical and electrophysiological tests as well as special imaging including autofluorescence, infrared and red free imaging and spectral-domain optical coherence tomography, in patients in whom a non-organic origin for visual loss is suspected. Results Inherited retinal diseases such as Stargardt macular dystrophy, X-linked retinoschisis and cone dystrophy as well as Batten disease in their early stages all need to be excluded when visual loss is thought to be non-organic. In addition, several acquired retinal conditions such as acute acular neuroretinopathy need to be taken into account. visual field testing, ISCEV-standard full-field flash electroretinography, pattern electroretinography and visual evoked potentials and specialised imaging techniques contribute significantly to making the correct diagnosis. Conclusion Visual loss in a list of organic conditions may mimic non-organic visual loss. Functional testing as well as specialised imaging techniques are essential in differentiating true organic from non-organic visual loss. [source]

4351: Using the OHTS-EGPS risk calculator with OctopusTM visual field testing

ACTA OPHTHALMOLOGICA, Issue 2010
AM STEVENS
Purpose Assessing risk in ocular hypertensive (OHT)patients is not only of clinical importance for the patients with regard to their possible glaucomatous field damage but has major repercussions on their quality of life when making decisions about the use of eye drops for longer periods. Clinicians are not that good in estimating the risk hence the need for instruments to help them make a more evidence-based decision. The EGPS group states that a methodological difference " of using in a quarter of the patients another type of perimeter could explain the Hasard Ratio for the Pattern Standard Deviation (PSD) of 1.66 in EGPS and 1.27 in OHTS . Hence our interest to recalculate a conversion of the Octopus G1 program ( mostly used for glaucoma ) to the Humphrey 30-2 in a Group of ocular hypertensives conform the inclusions of the OHTS thus providing a way to use the calculator more accurately. Methods 50 OHT patients recruited using the OHTS criteria were tested both with the Humphrey 30-2 program and the Octopus G1 program. The Humphrey PSD values were plotted against the square root of the Loss of Variance (sLV) and a conversion formula was calculated Results Our data generated the following conversion formula: Y = 0.4X + 1.1 Conclusion Our conversion permits a proper use of the risk calculator in OHT patients. There has been an attempt to convert the values from Humphrey 30-2 to Octopus 32 by Monhart based on the results of a study by Langerhorst. Another approach could be based on the algorithm described by Zeyen using HFA 24-2 and G1 Octopus but proves difficult to use in daily practice. EGPS simply used "converted" indices by taking the square root of LV for PSD. Our formula is based on the same population as OHTS but yields different results [source]

Anatomical and functional outcome in brilliant blue G assisted chromovitrectomy

ACTA OPHTHALMOLOGICA, Issue 5 2010
Paul B. Henrich
Abstract. Purpose:, To evaluate the potential of brilliant blue G (BBG) for intraoperative staining of the inner limiting membrane (ILM) with respect to staining properties and surgical outcome. Methods:, In a retrospective, non-comparative clinical case series, we analysed 17 consecutive chromovitrectomy interventions for surgery of macular holes, ERMs, vitreoretinal traction syndromes and cystoid macular oedema. Following complete posterior vitreous detachment, BBG was injected into the vitreous cavity at a concentration of 0.25 mg/ml, followed by immediate washout. Main outcome measures were staining properties, visual acuity, central visual field testing and optical coherence tomography (OCT) measurements over a mean follow-up period of 3 months. Results:, ILM staining was somewhat less intensive for BBG than for average indocyanine green (ICG) chromovitrectomy. However, the ILM was removed successfully without additional ICG in 15/17 patients. Postoperative visual acuity was improved in 16/17 patients and remained unchanged in one patient. Central retinal OCT thickness showed a postoperative reduction, with values ranging from +7 to ,295 ,m (median ,89 ,m). Neither visual field defects nor any other adverse events were recorded. Conclusion:, BBG permits sufficient staining for safe ILM removal. In this short-term study, good anatomical and functional results were achieved and no adverse events were observed. [source]

Combined intravitreal anti-vascular endothelial growth factor (Avastin®) and photodynamic therapy to treat retinal juxtapapillary capillary haemangioma

Temporal visual field defects are associated with monocular inattention in chiasmal pathology

ACTA OPHTHALMOLOGICA, Issue 7 2009
Hans C. FledeliusArticle first published online: 24 OCT 200
Abstract. Purpose:, Chiasmal lesions have been shown to give rise occasionally to uni-ocular temporal inattention, which cannot be compensated for by volitional eye movement. This article describes the assessments of 46 such patients with chiasmal pathology. It aims to determine the clinical spectrum of this disorder, including interference with reading. Methods:, Retrospective consecutive observational clinical case study over a 7-year period comprising 46 patients with chiasmal field loss of varying degrees. Observation of reading behaviour during monocular visual acuity testing ascertained from consecutive patients who appeared unable to read optotypes on the temporal side of the chart. Visual fields were evaluated by kinetic (Goldmann) and static (Octopus) techniques. Five patients who clearly manifested this condition are presented in more detail. The results of visual field testing were related to absence or presence of uni-ocular visual inattentive behaviour for distance visual acuity testing and/or reading printed text. Results:, Despite normal eye movements, the 46 patients making up the clinical series perceived only optotypes in the nasal part of the chart, in one eye or in both, when tested for each eye in turn. The temporal optotypes were ignored, and this behaviour persisted despite instruction to search for any additional letters temporal to those, which had been seen. This phenomenon of unilateral visual inattention held for both eyes in 18 and was unilateral in the remaining 28 patients. Partial or full reversibility after treatment was recorded in 21 of the 39 for whom reliable follow-up data were available. Reading a text was affected in 24 individuals, and permanently so in six. Conclusion:, A neglect-like spatial unawareness and a lack of cognitive compensation for varying degrees of temporal visual field loss were present in all the patients observed. Not only is visual field loss a feature of chiasmal pathology, but the higher visual function of affording attention within the temporal visual field by means of using conscious thought to invoke appropriate compensatory eye movement was also absent. This suggests the possibility of ,trans-synaptic dysfunction' caused by loss of visual input to higher visual centres. When inattention to the temporal side is manifest on monocular visual testing it should raise the suspicion of chiasmal pathology. [source]

Fitness to drive in glaucoma patients- Preliminary study results

ACTA OPHTHALMOLOGICA, Issue 2009
AM STEVENS
Purpose To develop a useful binocular 30° visual field criterion to predict safe driving behaviour in glaucoma patients by comparing perimetric data with an actual driving test on the road. Methods The sample will consist of 200 driving glaucoma patients, recruited in 2 university based glaucoma clinics (Ghent and Leuven, Belgium). Inclusion criteria are glaucomatous optic disc damage and/or glaucomatous field defects. Exclusion criteria are concomitant ocular disease, cataract > LOCS 2, systemic disease or medication affecting the visual field. Data collection will include demographic and medical data, driving habits, and Mini Mental Status. A complete ophthalmic examination wil be done including Goldmann, SAP and Esterman visual field testing. In addition, UFOV test, stereopsis and contrast sensitivity testing will be performed. All subjects will perform an on the road driving test with a driving expert of the Belgian Institute for Traffic Safety. Subjects can pass, fail, or pass the test with limitations. An attempt will be made to develop an algorithm of visual field abnormalities that predict as accurately as possible the outcome of the practical driving test. Results Preliminary results of the first 50 included patients will be presented. [source]

Retinal nerve fiber layer thickness and central corneal thickness in ocular hypertensive patients and healthy subjects

ACTA OPHTHALMOLOGICA, Issue 2009
AM BRON
Purpose To establish the correlation between central corneal thickness (CCT) and retinal nerve fiber layer (RNFL) thickness in ocular hypertensive patients and healthy subjects. Methods We prospectively collected charts of healthy subjects and ocular hypertensive (OHT) patients in one academic center between 2007 and 2008. OHT patients were defined by two measurements of intraocular pressure superior to 21mmHg without treatment, open angle in gonioscopy, normal appearing optic nerve head and normal visual field test Standard Automated Perimetry (SAP SITA) and Frequency Doubling Technique (FDT). Every patient underwent a standard clinical examination including optic nerve head examination, intraocular pressure, CCT measurement by ultrasonic (US) and anterior segment OCT pachymetry, visual field testing (SAP and FDT), RNFL thickness by scanning laser polarimetry (GDX-VCC) and optical coherence tomography (OCT). Results Eighty healthy subjects and 60 OHT patients were included. A correlation between US CCT and OCT CCT was found in both groups (r2=0.85 and r2= 0.87, p<0.001). There was no significant difference (p>0.15) in GDX-VCC and OCT RNFL thickness in both groups. In controls there was no correlation of any RNFL thickness measurement with the CCT. In OHT patients, the US CCT was weakly correlated with the average TSNIT evaluated by GDX-VCC (r2= 0.04, p<0.02). Conclusion This study did not show any relevant correlation between the RNFL thickness evaluated by GDX-VCC and the US CCT in healthy individuals and in OHT patients with a normal FDT. [source]

Visual field assessment and the Austroads driving standard

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 1 2002
Isabel M McLean MB BS
Abstract Purpose:,To compare the conventional (Humphrey 24-2) automated visual field testing with the Goldmann standard visual field test for driving, and to predict how many patients with glaucoma may not meet the Australian driving standard with respect to visual fields. Methods: Four patients (retinitis pigmentosa, glaucoma or vigabatrin treatment) with marked visual field defects as determined by uniocular static computerized perimetry (conventional testing) were re-evaluated with binocular kinetic Goldmann IV4e target field test (Australian driving standard). A series of 48 consecutive patients seen by the Glaucoma Inheritance Study in Tasmania were assessed with both static computerized perimetry and the Goldmann IV4e target test. Results:,The four patients with severe visual field defects (on computerized perimetry) were found to meet the driving standard on the binocular Goldmann IV4e target test. On computerized perimetry, 15 of 48 patients from the Glaucoma Inheritance Study in Tasmania were found to have visual field defects of sufficient severity that they may not meet the driving standard. However, only five of these patients failed the driving standard for visual fields, two of whom were still driving. Conclusions:,Patients with severe field defects on conventional uniocular automated perimetry may still meet the Goldmann standard visual field test for driving. Approximately 30% of glaucoma patients would have visual field loss shown on Humphrey 24-2 test of a severity that requires further testing to determine if they meet the driving standard. Ten per cent of glaucoma patients tested did not meet the driving standard for visual fields. [source]

CASE REPORT: Clinical application of mfERG/VEP in assessing superior altitudinal hemifield loss

CLINICAL AND EXPERIMENTAL OPTOMETRY, Issue 4 2005
Dr Henry Ho-lung Chan PhD FAAO
Multifocal ERG (mfERG) and multifocal VEP (mfVEP) have been used widely in the investigation of pathological changes or functional variations in the visual system. Altitudinal hemifield loss is a visual field defect that is usually found in patients with ischaemic optic neuropathy (ION). Anterior ischaemic optic neuropathy (AION) is a complex multi-factorial disease and it is difficult to diagnose according to clinical symptoms and signs alone. AION is believed to be caused by an infarction of the optic nerve due to the occlusion of the posterior ciliary arteries. The current report presents a patient diagnosed with non-arteritic AION. In this report, the mfERG findings did not match the results of the visual field test but those of the mfVEP did. After consideration of the visual electrophysiological and visual field results, the defect arises from neither the retina nor the visual pathway behind the optic chiasma. Hence, the optic nerve is the most likely location of the lesion, causing the superior altitudinal hemi-field loss. This report shows that the mfERG and mfVEP techniques can be used for objective visual field assessment to supplement the conventional visual field testing. [source]