Visual Field Defects in Ocular Hypertension and Glaucoma

Neima, David; LeBlanc, Raymond P.; Regan, D.

doi:10.1001/archopht.1984.01040030844029

Cited by 31 publications

(11 citation statements)

References 20 publications

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“…While many of these pat terns are artifacts of the kinetic testing strate gies used, there is still considerable histopatho logic and ophthalmoscopic evidence for the hy pothesis that glaucoma progresses due to localized damage, of the optic nerve head [4], If the early loss in glaucoma were purely local ized, then the CLV might be elevated with the MD little affected. Recent advances in com puterized perimetry, contrast sensitivity mea surement [5,6] and other psychophysical and clectrophysiological testing strategies have led to evidence that early loss in the chronic glau comas may be diffuse [7], Purely diffuse, sym metric loss would be manifest on the global indices by a disproportionate increase in the MD as compared to the CLV.…”

Section: Discussionmentioning

confidence: 41%

The Relationship of Mean Defect to Corrected Loss Variance in Glaucoma and Ocular Hypertension

Tj³

1990

Ophthalmologica

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Statistical analysis of visual-field data is permitted by the quantitative techniques used in automated perimetry. The visual-field indices mean defect (MD) and corrected loss variance (CLV) provide an opportunity to analyze and follow visual fields mathematically. We investigated the relationship of MD to CLV in 32 glaucoma suspects and 17 patients with visual-field defects due to chronic open-angle glaucoma. In glaucoma patients with early and moderate disease (up to a MD of 18 dB), the CLV statistically covaried with the MD (R² = 0.85). Beyond an MD of 18 dB, increases in the MD seemed to cause a decline in the CLV. These results differ from prior reports on the relationship of MD and CLV. Reasons for this and implications for the use of these statistics in the clinical management of the glaucoma patient are discussed. These results may be helpful in the understanding of the pathophysiologic basis of damage in glaucoma.

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Section: Discussionmentioning

confidence: 41%

The Relationship of Mean Defect to Corrected Loss Variance in Glaucoma and Ocular Hypertension

Tj³

1990

Ophthalmologica

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“…Several studies have demonstrated that glaucomatous and OHT eyes with normal Snellen acuities and with either normal visual fields or with defects far from fixation show abnormalities of foveal contrast sensitivity using stimulus field sizes between 3-6 degrees of visual angle (Atkin et al, 1979(Atkin et al, , 1983Motolko and Phelps, 1984;Neima, LeBlanc and Regan, 1984;Ross, 1985). 2.…”

Section: Discussionmentioning

confidence: 45%

Electrophysiological evidence that early glaucoma affects foveal vision

Marx¹,

Bódis-Wollner

Lustgarten³

et al. 1987

Doc Ophthalmol

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The pattern electroretinogram (PERG) and visual evoked potential (PVEP) were recorded simultaneously using a 1.1 cpd pattern which was counterphase modulated at 1 Hz. The responses of ocular hypertensive (OHT) eyes (with normal visual fields) and eyes with early glaucoma (with early visual field defects and/or early cupping of the optic nervehead) were compared to age-matched normal observers. All patients (26 eyes) and normal observers (14 eyes) had normal transient flash electroretinograms. Delays were seen in mean PERG latency in both OHT and early glaucoma eyes, while mean PERG amplitude was significantly reduced only in the early glaucoma eyes. The PVEP responses were 'unmeasurable' in 11/26 patient eyes because the waveforms were grossly abnormal in shape, making it impossible to identify the N- and P-components. The data were categorized in this manner: a patient response was considered abnormal if latency or amplitude exceeded normal limits (PERG or PVEP) or if the waveform was 'unmeasurable' due to its shape (PVEP only). Of the 26 patient eyes, we found that 8 eyes had normal PERG and PVEP, 11 eyes had abnormal PERG and PVEP, one eye had an abnormal PERG and a normal PVEP, and 6 eyes (3 patients) had a normal PERG and an abnormal PVEP. These data support the proposition that foveal vision (as assessed by the PVEP) may be affected by early glaucomatous damage. The relationship between the PERG and PVEP also was evaluated using a new measurement which we call the 'latency window'. Using this measurement, 15/26 patient eyes were abnormal-9 of these had 'unmeasurable' PVEPs. This measurement could be useful in classifying 'W'-shaped PVEPs as normal or abnormal.

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“…Evaluation of contrast sensitivity has demonstrated visual deficit in a variety of ocular conditions [3][4][5][6][7][8][9][10][11][16][17][18].…”

Section: Discussionmentioning

confidence: 41%

“…It is common experience that some patients continue to complain about their poor vision, even though they possess good visual acuity by standard tests in the examination room. This visual deficit can be determined by measuring spatial contrast sensitivity functions, as been shown in cases of corneal oedema [3], cataract [4], ocular hypertension [5,6], glaucoma [5,7,8], optic neuritis [2], multiple sclerosis [9][10][11] and several other conditions. Modern contrast sensitivity tests consist of computer generated sinusoidal grating patterns, i.e.…”

Section: Introductionmentioning

confidence: 44%

VCTS chart evaluation as a screening test

1988

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Contrast sensitivity curves of 211 randomly selected patients were drawn using the VCTS chart. Depending on the type of curve obtained, patients were grouped in different diagnostic categories following the instructions supplied with the chart. Clinical examination revealed that the VCTS chart curves indicated a false diagnosis of cataract in 65.5% patients and in 54.2% patients a false diagnosis of glaucoma. In a number of additional patients, VCTS chart testing had failed to indicate the presence of cataract or glaucoma. Contrary to the claims of the manufacturer our results demonstrate that the VCTS chart has no value as a screening device in a clinical practice.

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Visual Field Defects in Ocular Hypertension and Glaucoma

Cited by 31 publications

References 20 publications

The Relationship of Mean Defect to Corrected Loss Variance in Glaucoma and Ocular Hypertension

The Relationship of Mean Defect to Corrected Loss Variance in Glaucoma and Ocular Hypertension

Electrophysiological evidence that early glaucoma affects foveal vision

VCTS chart evaluation as a screening test

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