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Impressum
Long-term follow-up of the optic nerve head in patients with ocular hypertension using the "photo-flicker test"
Walter S., Meyer J., Funk J.
Universitäts-Augenklinik, Killianstr. 5, D-79106 Freiburg
Patients with ocular hypertension have a risk of 1 % per year to develop
glaucoma. Therefore, a regular monitoring of the visual field and the
optic nerve head is necessary. With the "photo-flicker test"
an easy method to compare the photos of the papillae over a period of
time is available.
Method: In a prospective study we examined 129 eyes of 68 patients
with a follow-up of 90 +/-15 months. Inclusion criteria were: acuity >
0,8, intraocular pressure > 25 mm Hg or >23 mm Hg with additional
risk factors for glaucoma. Every 6 months a clinical examination was performed
including determination of intraocular pressure by applanation, measurement
of the visual field with the Octopus 1-2-3 (G1x-program) and photography
of the optic nerve head. These photos were digitized and picture size
and angle of view were aligned using a software program (analySIS-CCS®,
CCS-Pawlowski GmbH, Jena, Germany). Then the photos were viewed on a monitor
in rapid change (flicker module). Two different examiners performed the
"flicker test" without knowledge of the patient data.
Results: The intra-individual reproducibility was 97,7%, the inter-individual
reproducibility was 93,8%. In 11 of the 129 eyes examined changes in the
appearance of the optic nerve head could be detected over the time course.
In 4 of 4 eyes which developed a visual field defect, a decrease of the
neuroretinal rim area could be seen in the "photo-flicker test".
Additionally, in 7 eyes with no visual field defect a deterioration of
the neuroretinal rim area was observed.
Conclusion: The "photo-flicker test" is an easy and fast
method to detect changes of the appearance of the optic nerve head with
a high reliability. Glaucomatous changes of the optic nerve head often
can be seen before visual field defects occur.