Purpose: To compare the diagnostic effectiveness of non-standard perimetry and standard automated perimetry (SAP) during earlystage monitoring of primary open-angle glaucoma (POAG).Patients and methods. The study involved 30 patients (46 eyes) with early-stage of POAG, aged 30 to 65 years (54.9 ± 1.3), who were under ongoing monitoring for 3 to 4 years (3.50 ± 0.68 years). All subjects, in addition to the standard ophthalmological examination, performed the threshold program “24-2” perimetry using the Humphrey II, the own modification of Frequency Doubling Technology (FDT) Perimetry, in the form of 2 threshold strategies: the wellknown “FDT-16” and the new “FDT-64”. The condition of the optic nerve head (ONH) was assessed using HRT 3 (Heidelberg Retina Tomograph, Germany) and OCT — Topcon 3D OCT- 2000 (TOPCON, Japan). During monitoring, RTVue FD-OCT (Optovue, USA) was additionally performed, evaluating the parameters of the retinal ganglion cell complex (GCC).Results. Regular follow-up, the implementation of the prescribed treatment contributed to the stabilization of glaucoma, as evidenced by the stability of the average MD index values according to all 3 threshold strategies, but reliably (p = 0.000) only according to SAP data. According to the criterion of the number of scotomas, there was a weakly expressed, but statistically significant negative dynamics for all the compared strategies. According to the results of the structural assessment of the ONH (the size of the excavation), a weakly pronounced negative dynamics was obtained in dynamics according to both HRT and OCT data. The average MD index values, the number of scotomas according to the three perimeter strategies and the excavation size based on HRT and OCT in patients with early-stage of POAG turned out to be stronger and more significant using the “FDT-16”, and the correlation characteristics with the results of “24-2” HFA II, “FDT-64” largely coincided.Conclusion. A reliable correlation between structural and functional parameters indicates the feasibility of using “FDT-64” in combination with SAP not only in for the diagnosis of the early-stage of glaucoma, but also in assessing its course. The sensitivity level of the results of “FDT-64” (100 %) compared to “FDT-16” (88 %) in patients with POAG was higher, therefore, “FDT-64” is advisable to use in complex diagnostic cases and in monitoring glaucoma.

PURPOSE. To compare the diagnostic effectiveness of two perimetric threshold strategies with frequency-doubling technology in patients with early primary open-angle glaucoma (POAG), the optical form of multiple sclerosis (MS) and papilledema in an open-label comparative clinical study.MATERIAL AND METHODS. The study involved 78 patients (105 eyes) with optic neuropathies (ON). The patients were divided into 3 groups depending on the etiology of optic neuropathy: the first group included 30 patients (46 eyes) with early POAG aged 30 to 65 years (54.9±1.3); the second group included 26 patients (26 eyes) diagnosed with the optic form of MS (an episode of retrobulbar optic neuritis in the medical history) aged 22 to 44 years (33.7±6.5); the third group consisted of 22 patients (33 eyes) aged from 18 to 66 years (35.7±14.9) with papilledema caused in the majority of cases by various brain tumors (25 eyes or 75.7%). The fourth (control) group consisted of 60 healthy individuals (60 eyes) aged 20 to 65 years, who were divided into 2 equal subgroups – younger (24.8±4.4) and older (56.4±3.9).Standard and non-standard perimetry was performed on all subjects during a comprehensive ophthalmic examination using the Humphrey 745i Visual Field Analyzer II (HFA II, «24-2» threshold strategy) (Germany-USA) and the author's own modification of Frequency Doubling Technology (FDT) Perimetry, in the form of 2 threshold strategies: the well-known «FDT-16» and the new «FDT-64».RESULTS. Both the «FDT-16» and the «FDT-64» threshold strategies were more effective in diagnosing glaucomatous optic neuropathy (GON), as confirmed by the higher sensitivity of their results to two criteria — the number of identified scotomas (n of scotomas n≥2), and the number of scotoma clusters in patients with POAG (88 and 100%; 95 and 83%, respectively) compared with those in patients with MS (61 and 76%; 85 and 54%, respectively) and papilledema (51 and 78%; 88 and 70%, respectively). The specificity of the «FDT-16» and «FDT-64» threshold strategies was significantly higher than the specificity of Humphrey perimetry (100, 80 and 63%, respectively).CONCLUSION. Both perimetric threshold strategies with frequency-doubling technology were found to be the most effective in detecting GON. This confirms that they are more sensitive in patients with early POAG when compared with the sensitivity in patients with MS and papilledema. The level of specificity of both FDT perimetry strategies far exceeds the level of specificity of Humphrey perimetry data, which indicates the advantage of FDT perimetry in separating healthy people from patients with ON, and not only of glaucoma genesis.

The article presents an interesting and fairly rare clinical case of congenital posterior segment anomaly of both eyes manifesting itself by coloboma of the optic nerve head in the right eye and choroidal coloboma in the left eye. For the first time, this pathology was diagnosed in our female patient at the age of 48. (For citation: Simakova IL, Kirillov YuA, Sosnovskiy SV, et al. Combination of congenital optic never coloboma in one eye and congenital choroidal coloboma in the fellow eye. Ophthalmology Journal. 2017;10(3):85-90. doi: 10.17816/OV10385-90).

Modern computer perimetry is divided into traditional white stimulus-on-white background, the gold standard of which is perimetry performed by using expert class perimeters Humphrey and Octopus and therefore called standard automatic or automated perimetry (SAP), and non-traditional or non-standard perimetry, which differs, first of all, in a different nature of a stimulus. The article is a review devoted to the assessment of the diagnostic capabilities of non-standard computer perimetry in the form of different variants of perimetry with doubling the spatial frequency (Frequency Doubling Technology Perimetry or FDT perimetry), which is performed by using perimeters of the 1st (Carl Zeiss Humphrey 710 Visual Field / FDT, 1997) and the 2nd (Carl Zeiss Humphrey Matrix / HM 715, 800 Visual Field Analyzer, 2005, 2010) generation. Most authors consider that FDT perimetry is effective in a glaucoma screening and, possibly, in monitoring a glaucomatous process, but only a few authors consider that non-standard perimetry method can be useful in diagnosing optic neuropathies of a different nature.