Threshold Static Automated Perimetry of the Full Visual Field in Idiopathic Intracranial Hypertension

Abstract

PURPOSE. To characterize visual loss across the full visual field in idiopathic intracranial hypertension (IIH) patients with mild central visual loss. METHODS. We tested the full visual field (508 nasal, 808 temporal, 308 superior, 458 inferior) of 1 eye of 39 IIH patients by using static perimetry (size V) with the Open Perimetry Interface. Participants met the Dandy criteria for IIH and had at least Frisén grade 1 papilledema with better than À5 dB mean deviation (MD) centrally. Two observers (MW and AS) evaluated the visual field defects, adjudicated any differences, and reviewed optical coherence tomography data. RESULTS. We found a greater MD loss peripherally than centrally (central 268). The median MD (and corresponding median absolute deviations) was À1.37 dB (1.61 dB) for the periphery and À0.77 dB (0.87 dB) for the central 268, P < 0.001. There were about 30% more abnormal test locations identified in the periphery (P ¼ 0.12), and the mean defect depth increased with eccentricity (P < 0.001). The most frequent defect found was a temporal wedge (23% of cases) in the periphery with another 23% that included this sector with inferior temporal loss. Although the presence of papilledema limited correlation, 55% of the temporal wedge defects had optical coherence tomography retinal nerve fiber layer deficits in the corresponding superonasal location. Other common visual field defects were inferonasal loss, superonasal loss, and superior and inferior arcuate defects. Seven patients (18%) had visual field defects in the periphery with normal central visual field testing. CONCLUSION. In IIH patients, we found substantial visual loss both outside 308 of the visual field and inside 308 with the depth of the defect increasing linearly with eccentricity. Temporal wedge defects were the most common visual field defect in the periphery. Static threshold perimetry of the full visual field appears to be clinically useful in IIH patients.

The Open Perimetry Initiative: a framework for cross-platform development for the new generation of portable perimeters

“…It The OPI was used to run a series of tests of the full visual field. [8][9][10][11] A publicly available dataset of 98 eyes of 98 healthy subjects 8 was used to derive normative values with the visualFields R package. 2 Figure 2 shows a statistical analysis of the results for a specific full visual field, which consists of the combined analysis of two tests taken on the same day, one for the central visual field and another for the far periphery.…”

“…Figure 5 shows a web app developed for the Daydream OPI running the updated ZEST algorithm with an irregular grid of test locations, that corresponds to the central part in the full visual field tests. [8][9][10][11] Although in this application the background was black for the contralateral eye (left half of the screen), the Daydream OPI implementation allows for the presentation of the same background luminance on both eyes.…”

Self-examination low-cost full-field OCT (SELFF-OCT) for patients with various macular diseases

“…Other research groups have also addressed the question to make OCT home-care compatible [ 22 – 24 ]. Recently, a design for a low-cost spectral domain OCT (SD-OCT) with component costs of below US$6000 was published [ 22 ].…”

“…Therefore, it is unknown how suitable the device would be for self-examination. Currently, a home-care OCT solution is under testing by the company Notal Vision [ 24 ]. Their device uses conventional SD-OCT technology and is also not expected to be cheaper than the low-cost OCT published [ 22 ].…”

Stauungspapille, Pseudotumor cerebri und idiopathische intrakranielle Hypertension – Was gibt es Neues?

“…Bei länger bestehender Stauung treten jedoch Gesichtsfeldausfälle auf, diese sind sehr heterogenzum Teil nasal unten, ähnlich wie bei einer AION, was auf eine ischämische Komponente bei chronischer STP hinweist [30]. Neuere Arbeiten zeigen mittels statischer Perimetrie am häufigsten keilförmige, temporale Gesichtsfelddefekte bei Patienten mit IIH [31] oder bogenförmige, glaukomähnliche Ausfälle [32]. Neben Gesichtsfeldausfällen bedingt ein erhöhter Hirndruck auch noch weitere ophthalmologische Symptome, die abgefragt werden sollten: transiente visuelle Obskurationen in Form von sekundenlangen Sehminderungen bei Lagewechsel z.…”