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Impressum
Comparison of the normal bracketing and the fast strategy of "Tendency Oriented Perimetry" (TOP) in glaucoma
Dannheim F.
Augenarztpraxis, Seevetal-Hittfeld
Objective: Comparison of visual fields with different degrees
of glaucoma-tous alterations, obtained with both strategies, by duration,
reproducibility, conformity, mean defect (MD), loss variance (LV), and
by inspection.
Methods: Visual fields of 27 glaucomatous eyes of 21 subjects were
examined twice with the normal bracketing and twice with the TOP strategy
of the OCTOPUS 1-2-3 perimeter in variable order using program G1X. The
fields included 4 borderline, 5 mild, 5 moderate and 13 severe defects.
Results: Duration with the normal strategy was 11.2 ± 0.68,
with the TOP strategy only 2.25 ± 0.18 minutes - a gain in time
of 80 ± 2 %.
Reproducibility for each of the two strategies, calculated as short term
fluctuation (SF), is for the normal strategy 4.04 ± 1.05, for TOP
4.19 ± 1.23. Three eyes with borderline or mild defects had a considerably
larger SF for TOP. Reproducibility as correlation coefficient of relative
sensitivity values within each strategy is in moderate or severe alterations
for both strategies in the same order with values around 0.8 except for
one outlier.
Conformity of results for both strategies, calculated as SF between the
mean values of relative sensitivity for either strategy, is 3.93 ±
0.94, slightly smaller than the within-strategy SF. Conformity as correlation
coefficient between mean values of relative sensitivity for either strategy
is in eyes with moderate and severe defects in the range of 0.81 to 0.91
(0.84 ± 0.09). The independent regression line of this correlation
shows a slope of 0.82 to 0.91, an intercept of 0.35 to 2.93. TOP apparently
levels the different defect values mildly reducing LV, whereas MD is equal
for both.
Inspection shows an excellent to reasonable good coincidence of fields
for both strategies in all cases. Fields with moderate or severe defects
agreed better than lesser affected ones. The 4 most deviating results
are presented.
Conclusion: The TOP strategy saves 80 % of examination time thus
avoiding fatigue. This fast threshold method proved sufficiently reliable
for a routine application in glaucoma. A slight attenuation of defect
values with TOP calls for a continuous application in follow-up examinations.