Comparing retinal sensitivities on blue-on-yellow and green-on-yellow perimetry in glaucoma suspects

Purpose: To compare the retinal sensitivities between the blue?on?yellow perimetry (BYP)/short?wavelength automated perimetry (SWAP) and green?on?yellow perimetry (GYP) among patients with and without nuclear sclerosis among glaucoma suspects. Methods: After ophthalmic examination, patients were subjected to two perimetric tests: BYP and GYP. The visual field (VF) parameters were compared between the two perimeters (p < 0.05 was considered significant). Results: Fifty?five eyes of 39 patients with a mean age of 60.53 ± 9.70 years were included in the study. Twenty?one eyes had clear lens or pseudophakia. Twenty?six eyes had lower grades of nuclear sclerosis (NO2NC2, NO3NC3) and eight eyes had higher grades of cataract (NO4NC4, NO5NC5). The mean retinal sensitivity (RS) in BYP was 22.08 ± 5.02 (dB) and in GYP was 23.84 ± 5.50 (dB) (p = 0.08). The mean defect in BYP was ?2.56 ± 4.40 (dB) and in GYP was ?3.24 ± 5.05 (dB), pattern standard deviation (PSD) in BYP was 3.65 ± 1.91 (dB) and in GYP was 3.83 ± 1.99 (dB), and foveal threshold (FT) was 24.20 ± 4.32 (dB) in BYP and 28.10 ± 4.50 (dB) in GYP. The two perimeters showed good agreement by the Bland–Altman plot for all parameters. Fourteen eyes showed perimetric changes suggestive of glaucoma by BYP. In these, GYP had a sensitivity of 92.86% (95% CI of 66.13% to 99.82%) and specificity of 95.12% (95% CI of 83.47% to 99.40%). Conclusion: BYP and GYP show good agreement. They are comparable in clear media as well as in different grades of nuclear sclerosis. GYP showed good sensitivity and specificity compared to BYP.

Relationship between retinal sensitivity and disease activity in patients with psoriasis vulgaris

OBJECTIVES: Psoriasis is a hyperproliferative chronic inflammatory skin disease of unknown etiology and ocular structures and visual pathways can also be affected during the course of this disease. Subclinical optic neuritis has previously been observed in psoriatic patients in visual evoked potential studies. This trial was designed to evaluate retinal sensitivity in patients with psoriasis vulgaris. METHODS: A total of 40 eyes of 40 patients with chronic plaque-type psoriasis and 40 eyes of 40 age- and sex-matched control subjects were included in this study. The diagnosis of psoriasis was confirmed by skin biopsy. The severity was determined using the Psoriasis Area and Severity Index and the duration of the disease was recorded. After a full ophthalmological examination, including tests for color vision and pupil reactions, the visual field of each subject was assessed using both standard achromatic perimetry and short wavelength automated perimetry. RESULTS: The mean Psoriasis Area and Severity Index was 22.05±6.40′. There were no significant differences in the visual field parameters of subjects versus controls using either method. There were correlations between disease severity and the mean deviations in standard achromatic perimetry and short wavelength automated perimetry and between disease severity and the corrected pattern standard deviation and pattern standard deviation of short wavelength automated perimetry (r = -0.363, r = -0.399, r = 0.515 and r = 0.369, respectively). CONCLUSIONS: Retinal sensitivity appears to be affected by the severity of psoriasis vulgaris. .

The role of standard automated perimetry and newer functional methods for glaucoma diagnosis and follow-up.

Automated perimetry has become the mainstream for assessment of functional glaucomatous loss and progressive damage. Recent improvements with the Swedish interactive thresholding algorithm (SITA) strategy and the guided progression analysis (GPA) have further settled standard achromatic perimetry (SAP) as the preferred method for diagnosis and follow-up of functional loss. Although SAP is still considered the gold standard, function-specific perimetry may offer advantages for early diagnosis. Frequency doubling technology (FDT) and short-wavelength automated perimetry (SWAP) have been shown to be helpful, especially when SAP is normal and there is a suspicion of glaucoma. Studies using rarebit perimetry have also shown promising results. Studies have observed that each test identifies a different subset of eyes, and combining the tests may improve sensitivity. Nevertheless, the more sophisticated analyses do not reduce the importance of a correct interpretation of the test results.

Correlation between Retinal Nerve Fiber Layer Thickness and Visual Field in Normal Tension Glaucoma Patients

PURPOSE: To determine the correlation between retinal nerve fiber layer (RNFL) thickness and visual field defect for early detection of normal tension glaucoma (NTG). METHODS: Sixty eyes newly diagnosed with NTG and 50 normal eyes were analyzed by optical coherence tomography and a short wave length automated perimetry test. The relationship between RNFL, divided into 12 areas, and visual field, divided into 21 areas, were analyzed. RESULTS: Sixty eyes that revealed visual field defect by SWAP showed thinning of the RNFL. OCT sectors 6-o'clock, 7-o'clock, and 8-o'clock (inferior and inferotemporal) and SWAP visual field zones 13, 14, 15 and 16 (superior paracentral, arcuate areas, and the nasal step) were the most frequently damaged. The strongest associations were between the inferior and inferior temporal RNFL sectors 6, 7, and 8-o'clock and the superior nasal/arcuate visual field zones 13, 14, and 15 (R2 range=15.9-34.6%, all p<0.05). CONCLUSIONS: A combination of these two methods may be helpful for the early detection of NTG.

The Differences in Results of Short Wavelength Automated Perimetry According to Lens Opacities

PURPOSE: Perimetric examination plays an important role in the diagnosis of glaucoma, which is among the leading causes of blindness worldwide. Several examination methods have been developed for early detection of glaucoma. Among those, short-wavelength automated perimetry (SWAP) is the most widely investigated. In this study, the effects of nuclear opacities on SWAP were examined. METHODS: Lens opacities were divided into cortical and nuclear opacity groups ; each group consisted of fifteen eyes. The eyes studied underwent standard white-on-white perimetry and SWAP exams before and after cataract operation. The differences in the results of the examinations were compared between the two opacity groups. The t test was used for comparing the data. RESULTS: In the cortical opacity group, the average difference between the mean deviation before and after the operation was 5.46dB in white-on-white perimetry and 5.02dB in SWAP. In the nuclear opacity group, the average difference between the mean deviation before and after the operation was 4.01dB in white-on-white perimetry and 10.82dB in SWAP. There was no statistically significant difference in the cortical opacity group (p=0.6575). However, there was a statistically significant difference in the nuclear opacity group (p<0.0001). CONCLUSIONS: In clinical situations, more caution should be taken when interpreting the SWAP results of nuclear cataract patients in order to make an accurate decision.