Basic Perimetry

(1)

Basic Perimetry

Sonie Umbara, Andika Prahasta, Elsa Gustianty, Maula Rifada Fakultas Kedokteran Universitas Padjadjaran

PMN Rumah Sakit Mata Cicendo

(2)

Perimetry

• Standard method of measuring visual dysfunction in glaucoma

• Measures different light sensitivity (distinguish a stimulus from a uniform background)

Purposes:

• Identification & quantification of abnormal fields

• Detect progression & measure rates of change

(3)

Type

• Static perimetry

• Humphrey

• Octopus

• Kinetic perimetry

Confrontation

Tangent Screen

Goldmann

Humphrey Visual Field

(4)

July 26, 2017 EN_31_15

0_0039III

4 Real life translation of VF

(5)

PRINCIPLES

Based on Humphrey Visual Analyzer

(6)

Limit of Normal Visual Field

Nasal Temporal

(7)

July 26, 2017 EN_31_15

0_0039III

7 Hill of Vision

Threshold sensitivity (dB)

• The eye’s sensitivity varies depending on the retinal location and is often described as a “hill of vision”

Source. Basic Principles of Visual Field Testing

http://arapaho.nsuok.edu/~salmonto/vs2_lectures/Lab2.pdf 10dB

30dB 50dB

0dB

20dB

40dB

(8)

June 7, 2016

EN_31_150_0040II 8

Hill of Vision Nomenclature

Optic Disc

Extent of the visual field (~ -60°…+90°)

Central field (30°)

Macula (10°)

Nose / Nasal field

(9)

9

(10)

(11)

Single Field Analysis

Patient:

Rarahasti, Rati

Date of Birth: Oct 27, 1960 Gender: Female Patient ID: 926338

OD Single Field Analysis Central 30-2 Threshold Test

HFA 3 860-17732/1.5.2.431 Version 3.5.0.0 Created: 03/19/2021 11:00:22 by IT Page 1 of 1

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

4 7 2

9 6 8

5

1

3 10 RELIABILITY INDICES

NUMERICAL TOTAL DEVIATION MAP

TOTAL DEVIATION PROBABILITY MAP

NUMERICAL PATTERN DEVIATION MAP

THRESHOLD VALUE

GRAYSCALE MAP

GLAUCOMA HEMIFIELD TEST

VISUAL FIELD INDICES PATTERN DEVIATION

PROBABILITY MAP

PROBABILITY SYMBOLS 11

GAZE TRACKING

1. RELIABILITY INDICES 2. THRESHOLD VALUE 3. GRAYSCALE MAP

4. NUMERICAL TOTAL DEVIATION MAP 5. TOTAL DEVIATION PROBABILITY

6. NUMERICAL PATTERN DEVIATION MAP 7. PATTERN DEVIATION PROBABILITY MAP 8. GLAUCOMA HEMIFIELD TEST (GHT)

9. VISUAL FIELD INDICES 10. PROBABILITY SYMBOLS 11. GAZE TRACKING

IDENTITY

(12)

Reliability Indices

• False Positive Error: measure the tendency of patient to press button even when no stimulus has actually been seen (“trigger- happy patient). >15%àrepeat test

• False Negative Error: the patient doesn’t respond to supratreshold stimuli at normal test point. Inattentive or glaucomatous

visual field

• Fixation loss: the patient responds in blind spot. >20% àcompromised test

resultsàrepeat test

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

1 RELIABILITY INDICES

(13)

TH Value & Grayscale map

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

2 THRESHOLD VALUE 3

GRAYSCALE MAP THRESHOLD VALUES

The measured decibel sensitivity at each tested point, and is the basic information upon which all the other analyses and printouts are based.

GRAYSCALE MAP

An intuitive way of presenting raw decibel sensitivity, with dark areas indicating reduced sensitivity. However,

because the data are not compared to normal ranges, significant loss may be unrecognizable.

Can depicts artifactual loss or profound visual field

defect

(14)

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

4

5 NUMERICAL TOTAL DEVIATION MAP

TOTAL DEVIATION PROBABILITY MAP

NUMERICAL TOTAL DEVIATION MAP

The Numerical Total Deviation Plot shows decibel deviations from age-corrected, normal sensitivities.

TOTAL DEVIATION PROBABILITY MAP

The Total Deviation Probability Map (5) highlights deviations that fall

outside the statistical range of normal sensitivity.

(15)

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

7 6

NUMERICAL PATTERN DEVIATION MAP

PATTERN DEVIATION PROBABILITY MAP

PATTERN DEVIATION MAPS

The Pattern Deviation Maps highlight localized loss after first

correcting for any overall change in the height of the hill of

vision, such as that caused by cataract. This is the numerical

pattern deviation plot with deviations in dB.

(16)

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

8 GLAUCOMA HEMIFIELD TEST

• Compares local defects in 5 zones of the upper field with those found in mirror image zones in the lower hemifield

• Provides the result in clear text. ¹

1 Effective Perimetry. Heijl and Patella, p. 54.

2 Katz J et al. Comparison of Analytic Algorithms for Detecting Glaucomatous Visual Field Loss. Arch Ophthalmol, Vol. 109, 1991

Global Indices

GHT – Glaucoma Hemifield Test

Possible messages:

1. Outside normal limits

2. Borderline

3. General reduction of sensitivity

4. Abnormally high sensitivity

5. Within normal

limits

(17)

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

9 VISUAL FIELD INDICES

Mean Deviation (MD) - It is elevation or depression of the patient's overall field from normal reference.

Pattern Standard Deviation (PSD) - It is the standard

deviation of the difference between the threshold value at each

test location and expected value.

(18)

Visual Field Index (VFI)

§ VFI is a percentage (0-100%) reflecting the remaining Quality- of-Vision derived from the

deviations in a visual field.

§ 100% means the quality of life is not affected.

§ The VFI cannot go beyond 100%

EN_31_150_0040II

Global Indices

VFI – Visual Field Index – Q-O-L indicator

June 7, 2016 18

(19)

Central points weighted more heavily than those on periphery Reduces cataract contribution to the measurement of VF loss

B has more damaged central points and thus a lower VFI than A ^.

A B

VFI = 90% VFI = 81%

Visual Field Index

Reflecting Quality of Life

June 7, 2016 EN_31_150_0040II 19

(20)

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

PROBABILITY SYMBOLS 10

PROBABILITY SYMBOLS

Probability of such value in normal population

(21)

Patient:

Rarahasti, Rati

OD Single Field Analysis Central 30-2 Threshold Test

Fixation Monitor:

Fixation Target:

Fixation Losses:

False POS Errors:

False NEG Errors:

Test Duration:

Fovea:

Gaze/Blind Spot Central 1/18 1%

14% 06:27

38 dB

Stimulus:

Background:

Strategy:

Pupil Diameter:

Visual Acuity:

Rx:

III, White 31.5 asb SITA Standard 3.0 mm +3.25 DS 0.8

Date:

Time:

Age:

Mar 19, 2021 10:40 AM 60

30° 30° 30°

11 19 <0 21 18 27 27 27 28 21 5 28 31 29 30 31 28 23

<0 17 31 32 31 31 31 28 27 21

<0 22 30 32 32 29 29 25 28 24 19 23 30 32 33 31 30 <0 27 28 14 24 31 32 31 31 30 30 28 22

21 27 30 28 28 26 29 30 17 26 23 23 26 26

12 20 18 19 -13 -5 -26 -2

-8 0 0 0 2 -4 -22 0 2 0 1 2 0 -4 -28-11 1 2 0 0 1 -2 -1 -6 -29 -7 -1 0 -1 -2 -2 -1 -5 -8 -7 -1 0 0 -1 -1 -3 -1 -12 -5 0 0 -1 -1 -1 -1 -2 -7

-6 -3 0 -3 -2 -4 -1 0 -10 -2 -6 -7 -3 -4

-15 -7 -10 -9

-14 -6 -26 -3 -9 -1 -1 0 2 -5 -23 -1 1 -1 0 2 -1 -4 -29-12 1 1 -1 0 0 -2 -2 -7 -29 -8 -2 -1 -1 -3 -3 -2 -5 -8 -7 -2 -1 0 -2 -2 -3 -2 -12 -5 0 -1 -2 -2 -2 -1 -3 -8

-7 -3 -1 -3 -3 -5 -2 0 -11 -3 -7 -7 -4 -4

-15 -8 -11-10

Total Deviation Pattern Deviation

GHT: Outside Normal Limits VFI24-2: 97%

MD30-2:

-2.72 dB P < 5%

PSD30-2: 5.62 dB P < 0.5%

P < 5%

P < 2%

P < 1%

P < 0.5%

Comments Signature

GAZE TRACKING

11 Record of Gaze direction

(22)

Strategy:

1. Full Threshold 2. Fastpac

3. SITA Standard 4. SITA Fast

5. SITA Faster

(23)

Is it Glaucoma?

• Confirmation of early glaucoma field defect :

• 1.Pattern deviation probability plot shows a cluster of > 3 non-edge points with p< 5% and one points has p<1%.

• 2.PSD or CPSD with p< 5%

• 3.GHT outside normal limits

(24)

Modified Mills Staging System

(25)

Examples

Cataract

Corneal opacity & glaucoma

(26)

Examples

Nasal step Arcuate Scotoma

(27)

References

• Heijl A, Patella VM, Bengtsson B. Effective Perimetry 5 ^th edition. Carl Zeiss Meditec, Inc. 2021.

• Katz J et al. Comparison of Analytic Algorithms for Detecting Glaucomatous Visual Field Loss. Arch Ophthalmol, Vol. 109, 1991

• Anderson DR, Patella VM. Automated Static Perimetry. Mosby. 1999.

(28)