Detección y caracterización de defectos del campo visual mediante perimetría Octopus en glaucoma congénito primario / Detection and characterisation of visual field defects using Octopus perimetry in congenital glaucoma

Detectar y caracterizar los defectos del campo visual (CV) mediante perimetría Octopus en pacientes con glaucoma congénito primario (GCP) y determinar la calidad y duración del CV. Material y métodos: Se incluyeron 88 ojos de 70 pacientes diagnosticados de GCP. Las evaluaciones se realizaron con un Octopus 900 y cada ojo se evaluó con el algoritmo de perimetría orientada por tendencias (G-TOP). Se recogieron datos cuantitativos de CV: datos de calidad (respuestas falsa positiva y negativa, y duración del tiempo) y resultados de desviación media (DM) y raíz cuadrada de la varianza de pérdida (sLV). También se recogieron datos cualitativos: presencia de defectos difusos y localizados, hemicampo afectado y grado de defectos utilizando la clasificación de Aulhorn y Karmeyer. Se analizaron las correlaciones entre los resultados perimétricos y las variables clínicas. Resultados: La mediana de edad fue de 11 (8-17) años. El 65,9% (58/88) de los ojos con GCP presentaban defectos de CV. Se observaron defectos difusos en 10/58 ojos (16,94%) (DM media=23,92 [DE: 2,52]) dB) y defectos localizados en 48/58 ojos (82,75%). El defecto más frecuente fue el escotoma incipiente paracentral (n=15), el escalón nasal (n=8), el defecto arciforme añadido (n=2), el semianular (n=13) y el defecto concéntrico con isla central (n=9). El hemicampo visual afectado con mayor frecuencia fue el inferior. La duración media de la prueba fue de 2min 12s (DE: 21,6s). Los valores MD y sLV se correlacionaron con la agudeza visual mejor corregida, la relación excavación/disco y el número de cirugías de glaucoma (todas p<0,001). Conclusión: Se identificó un alto número de defectos difusos y localizados utilizando la perimetría Octopus en pacientes con GCP. El defecto más frecuente fue el escotoma paracentral, y el hemicampo inferior fue el más afectado.(AU)

Purpose: To detect and characterise visual field (VF) defects using static Octopus perimetry in patients with primary congenital glaucoma (PCG) and to determine VF quality and time duration. Material and methods: Eighty-eight eyes of 70 patients diagnosed with PCG were included. Assessments were performed using an Octopus 900 and each eye was assessed with the tendency-oriented perimetry (G-TOP) algorithm. Quantitative VF data were collected: quality data (false positive and negative response, and time duration) and results of mean deviation (MD) and square root of loss variance (sLV). Qualitative data were collected: the presence of diffuse and localized defects, the affected hemifield and grade of defects using the Aulhorn and Karmeyer classification. Correlations between perimetric results and clinical variables were analysed. ResultsMedian age was 11 (8-17) years. 65.9% (58/88) of PCG eyes showed VF defects. Diffuse defects were observed in 10/58 eyes (16.94%) (mean MD=23.92 [SD: 2.52]) dB) and localized defects in 48/58 eyes (82.75%). The most frequent defect was spot-like/stroke-like/incipient paracentral scotoma (n=15), nasal step (n=8), adding arcuate defect (n=2), half ring-shaped (n=13) and concentric defect with a central island (n=9). And the most frequent affected visual hemifield was inferior hemifield. Mean test duration was 2min 12s (SD: 21.6s). MD and sLV values were correlated with best corrected visual acuity (BCVA), cup to disc ratio and number of antiglaucoma surgeries (all P<.001). Conclusion: A high number of diffuse and localized defects were identified using Octopus perimetry in PCG patients. The most frequent defect was paracentral scotoma and inferior hemifield was the most affected.(AU)

Detection and characterisation of visual field defects using Octopus perimetry in congenital glaucoma.

PURPOSE: To detect and characterise visual field (VF) defects using static Octopus perimetry in patients with primary congenital glaucoma (PCG) and to determine VF quality and time duration. MATERIAL AND METHODS: Eighty-eight eyes of 70 patients diagnosed with PCG were included. Assessments were performed using an Octopus 900 and each eye was assessed with the tendency-oriented perimetry (G-TOP) algorithm. Quantitative VF data were collected: quality data (false positive and negative response, and time duration) and results of mean deviation (MD) and square root of loss variance (sLV). Qualitative data were collected: the presence of diffuse and localized defects, the affected hemifield and grade of defects using the Aulhorn and Karmeyer classification. Correlations between perimetric results and clinical variables were analysed. RESULTS: Median age was 11 (8-17) years. 65.9% (58/88) of PCG eyes showed VF defects. Diffuse defects were observed in 10/58 eyes (16.94%) (mean MD = 23.92 [SD: 2.52]) dB) and localized defects in 48/58 eyes (82.75%). The most frequent defect was spot-like/stroke-like/incipient paracentral scotoma (n = 15), nasal step (n = 8), adding arcuate defect (n = 2), half ring-shaped (n = 13) and concentric defect with a central island (n = 9). And the most frequent affected visual hemifield was inferior hemifield. Mean test duration was 2 min 12 s (SD: 21.6 s). MD and sLV values were correlated with best corrected visual acuity (BCVA), cup to disc ratio and number of antiglaucoma surgeries (all P < .001). CONCLUSION: A high number of diffuse and localized defects were identified using Octopus perimetry in PCG patients. The most frequent defect was paracentral scotoma and inferior hemifield was the most affected.

Perimetría computadorizada no estandarizada

La perimetría tradicional estándar es la base de la introducción de innovaciones no convencionales, que continúan considerándola como punto de referencia para comparar su eficiencia y señalar sus desventajas. Aunque la mayoría de estas contribuciones se centran en el glaucoma, también existen informes significativos sobre resultados satisfactorios en otras enfermedades. El propósito de esta revisión es abordar la tendencia emergente de las pantallas y monitores de última generación que se integran con las computadoras. Estos avances resaltan la accesibilidad mejorada, la introducción de nuevos equipos y la incorporación de nuevos pasos, variables y grupos etarios. La búsqueda de información se concentró en la literatura publicada en línea, especialmente en inglés, de los últimos 5 y 17 años. En total, se identificaron y recuperaron 24 artículos: 17 de los últimos cinco años y 7 de los últimos 17 años. Se registraron 18 tecnologías diferentes que compararon sus resultados con la perimetría estándar. Estas tecnologías se clasificaron, para los propósitos del estudio, en dos categorías: aquellas basadas en computadora (en línea y fuera de línea) y aquellas asistidas por el monitor y acopladas a simulación.

Standardized traditional perimetry is the basis for the introduction of unconventional innovations, which continue to be considered as a benchmark to compare its efficiency and point out its disadvantages. Although most of these contributions focus on glaucoma, there are also significant reports of successful results in other diseases. The purpose of this review is to address the emerging trend of state-of-the-art screens and displays integrated with computers. These advances highlight improved accessibility, the introduction of new equipment, as well as the incorporation of new steps, variables and age groups. The search for information focused on the literature published online, especially in English, between the last 5 to 17 years. A sheer number of 24 articles were identified and retrieved, 17 from the last 5 years and 7 from the last 17 years. Eighteen different technologies were identified, whose results were compared to those of standardized perimetry. These technologies were classified, for the purposes of the study, into two categories: computer-based (online and offline), or display-assisted and simulation-coupled.

Evaluación de las secuelas clínicas y funcionales de la coriorretinopatía serosa central. Un análisis de serie de casos / Evaluation of clinical and functional sequels of central serous chorioretinopathy. A case series analysis

Objetivo: Evaluar las secuelas clínicas y funcionales de pacientes con diagnóstico de coriorretinopatía serosa central (CSC) resuelta, mediante OCT macular, prueba de sensibilidad al contraste, campo visual 10-2 y prueba de colores Farnsworth D-15. Métodos: Se incluyeron y evaluaron 27 ojos de 26 individuos con CSC resuelta por OCT macular; a los pacientes se les realizó prueba de sensibilidad al contraste con el equipo Optec 6500, campo visual 10-2 con Octopus 900 Haag- Streit y prueba de color Farnsworth D-15. Resultados: Se observaron secuelas en 20 ojos (74,1%) por OCT macular y en 21 (77,8%) en la sensibilidad al contraste, predominantemente defecto tipo2. También 27 (100%) tenían un campo visual 10-2 alterado correspondiente a sensibilidad foveal reducida, y 11 ojos (40,7%) correspondían a escotomas centrales y paracentrales. La prueba de color mostró alteración en 11 (40,7%) del total de ojos evaluados, encontrando tritanomalía en 9 de ellos (81,8%). No se observaron diferencias significativas en los estudios entre el grupo de observación vs el grupo de tratamiento. Conclusiones: La CSC puede dejar secuelas en la calidad visual de los pacientes a pesar de su tratamiento en fase aguda. La agudeza visual antes y después del tratamiento en el grupo de intervención no tuvo diferencia significativa. (AU)

Objective: To evaluate the clinical and functional sequelae of patients with a diagnosis of resolved central serous chorioretinopathy (CSC), through macular OCT, contrast sensitivity test, visual field 10-2 and Farnsworth D-15 color test. Methods: 27 eyes of 26 individuals with CSC resolved by macular OCT were included and evaluated. The patients underwent a contrast sensitivity test with the Optec 6500 equipment, a 10-2 visual field with an Octopus 900 Haag-Streit, and a Farnsworth D-15 color test. Results; Sequelae were observed in 20 eyes (74.1%) by macular OCT and in 21 (77.8%) in contrast sensitivity, predominantly type2 defect. Also 27 (100%) had a visual field 10-2 altered corresponding to reduced foveal sensitivity, 11 eyes (40.7%) corresponded to central and paracentral scotomas. The color test showed alteration in 11 (40.7%) of the total eyes evaluated, finding tritanomaly in 9 of them (81.8%). No significant differences were observed in the studies between observation group vs the treatment group. Conclusions: CSC can leave sequelae in the visual quality of patients despite treatment in the acute phase. Visual acuity before and after treatment in the intervention group had no significant difference. (AU)

Evaluation of clinical and functional sequels of central serous chorioretinopathy. A case series analysis.

OBJECTIVE: To evaluate the clinical and functional sequelae of patients with a diagnosis of resolved CSC, through macular OCT, contrast sensitivity test, visual field 10-2 and Farnsworth D-15 color test. METHODS: 27 eyes of 26 individuals with CSC resolved by macular OCT were included and evaluated; the patients underwent a contrast sensitivity test with the Optec 6500 equipment, a 10-2 visual field with an Octopus 900 Haag-Streit, and a Farnsworth D-15 color test. RESULTS: Sequelae were observed in 20 eyes (74.1%) by macular OCT and in 21 (77.8%) in contrast sensitivity, predominantly type 2 defect. Also 27 (100%) had a visual field 10-2 altered corresponding to reduced foveal sensitivity, 11 eyes (40.7%) corresponded to central and paracentral scotomas. The color test showed alteration in 11 (40.7%) of the total eyes evaluated, finding tritanomaly in 9 of them (81.8%). No significant differences were observed in the studies between observation group vs the treatment group. CONCLUSIONS: CSC can leave sequelae in the visual quality of patients despite treatment in the acute phase. Visual acuity before and after treatment in the intervention group had no significant difference.

Multichannel perimetric alterations in systemic lupus erythematosus treated with hydroxychloroquine.

Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease of unknown etiology with many clinical manifestations. We report the first case of SLE in which visual alterations were evaluated with multichannel perimetry. Some achromatic and color vision alterations may be present in SLE, especially when treated with hydroxychloroquine. The sensitivity losses detected in the chromatic channels in the central zone of the visual field were consistent with the results of the FM 100 Hue color test. Likewise, the multichannel perimetry detected sensitivity losses in the parafoveal area for both chromatic channels, especially for the blue-yellow.

Análise de regressão logística na combinação de métodos propedêuticos no diagnóstico do glaucoma / Logistic regression analysis in the combination of diagnostic methods in glaucoma

OBJETIVOS: Estudar a habilidade diagnóstica do tomógrafo retiniano de Heidelberg (HRT II), GDx analisador de fibras nervosas (GDx), perimetria azul-amarelo (SWAP), tecnologia de frequência duplicada (FDT) isoladamente e em conjunto no diagnóstico do glaucoma. MÉTODOS: Sessenta glaucomatosos e 60 pacientes normais foram submetidos a exames de HRT II, GDx, SWAP e FDT. HRT foi considerado alterado quando pelo menos uma região do anel neurorretiniano esteve fora dos limites da normalidade, conforme a análise de regressão de Moorfields. GDx alterado foi definido quando pelo menos um índice foi considerado pelo programa do equipamento como fora dos limites normais, excluindo-se o índice simetria, ou ainda quando no gráfico "the deviation from normal graph" apareceu um quadrante com significância abaixo de 5%. O FDT foi considerado anormal quando pelo menos uma região testada apresentou-se com defeito severo ou com a presença de dois defeitos moderados contíguos. Para o SWAP foram adotados os critérios de anormalidade propostos por Anderson. Análise de regressão logística foi realizada. RESULTADOS: Quando foram estudadas as tecnologias isoladamente, a análise de regressão logística apresentou melhores índices de razão das chances para glaucoma com exames positivos para o HRT (22,49), seguido pelo SWAP (21,71). FDT (3,97) e GDx (2,73). Quando se associaram exames positivos de diferentes tecnologias, as razões das chances aumentaram. Nos casos com exames de HRT, FDT e SWAP fora dos limites normais, a razão das chances foi de 252,6 e com HRT, SWAP e GDx alterados, 173,1. Quando associamos exames positivos de diferentes tecnologias, a razão das chances dos pacientes serem glaucomatosos aumentou consideravelmente, chegando a 689,7 com todos os exames fora dos limites normais, o que ocorreu em 26 pacientes deste estudo. CONCLUSÕES: A análise de regressão logística confirmou que a presença de exames alterados de HRT ou SWAP apresentam as maiores razões das chances de glaucoma. A associação de exames alterados aumentou a razão das chances, principalmente, quando o HRT e o SWAP estavam fora dos limites normais.

PURPOSES: In this research was studied the diagnostic ability of the Heidelberg Retinal Tomograph (HRT II), GDx nerve fiber analyzer (GDx), Short-wavelenght Automated Perimetry (SWAP) and Frequency-doubling technology (FDT), all of them together and also separately in the diagnosis of glaucoma. METHODS: Sixty glaucomatous patients and 60 normal ones were submitted to examination with the technology of HRT II, GDx, FDT and SWAP. In the interpretation of HRT, based on the Moorfields regression analysis, were considered abnormal when at least one area of the neuroretinal ring was outside the bounds of normality. GDx was defined as altered, when it was observed that at least one index was considered by equipment program as outside of normal limits, excluding the index symmetry, or when "the deviation from normal graph" appeared a quadrant with significance below 5%. The FDT was considered abnormal when at least one region tested presented with severe defects, or two contiguous moderate defects in at least two reliable tests. For SWAP was adopted the abnormality criteria proposed by Anderson. Logistic regression analysis was performed. RESULTS: When the technologies were studied separately, the Logistic regression analysis showed better odds ratio rates to test positive for glaucoma with HRT (22.49), followed by EAP (21.71), FDT (3.97) and GDx (2.73). When positive tests were associated with different technologies, the odds ratios increased. In cases with HRT, FDT and PAA tests, outside normal bounds, the odds ratio was 252.6. Concerning the HRT, GDx and PAA the result have changed to 173.1. When we associate positive tests from different technologies, the odds ratio of glaucomatous patients have increased considerably, reaching 689.7 with all the tests outside normal bounds, which have happened with 26 patients of this study. CONCLUSIONS: The Logistic Regression analysis confirmed that the abnormal tests of HRT and PAA have shown to be the highest reasons for glaucoma occurrence. The association of abnormal tests increased the odds ratio, especially when the HRT and PAA were out of normal bounds.

Importância da perimetria manual cinética na avaliação de pacientes com glaucoma avançado / Manual kinetic perimetry value to monitor advanced glaucomatous patients

OBJETIVO: Avaliar a importância da perimetria manual cinética (PMC) de Goldmann em pacientes com glaucoma e defeito de campo visual avançado à perimetria computadorizada automática estática (PAE) com perímetro Humphrey (PH). MÉTODOS: Realizou-se exame de PMC com perímetro de Goldmann (PG) em pacientes com glaucoma primário de ângulo aberto avançado que apresentavam defeito avançado ao exame de PAE com PH. Realizou-se ainda uma análise qualitativa da extensão do campo visual à perimetria de Goldmann destes pacientes. RESULTADOS: Os resultados encontram-se ilustrados de forma qualitativa. CONCLUSÃO: A PMC com PG mostrou-se útil para complementar a avaliação da real condição campimétrica de pacientes com glaucoma primário de ângulo aberto avançado.

PURPOSE: To evaluate the importance of Goldmann manual kinetic perimetry (MKP) in glaucomatous patients with advanced visual field loss in automated static perimetry (ASP) with Humphrey perimeter (HP). METHODS: The MKP with Goldmann perimeter (GP) was performed in patients with advanced primary open angle glaucoma with advanced visual field defect in the ASP with HP. A qualitative analysis was realized on the visual field extension in the Goldmann perimetry of these patients. RESULTS: The results are illustrated in a qualitative way. CONCLUSION: The MKP with GP was useful to complement the evaluation of the real campimetric condition of advanced primary open angle glaucomatous patients.

Resultados de la paquimetría ultrasónica en los pacientes diabéticos / Results of the ultrasonic pachymetry in diabetic patients

La Diabetes Mellitus es una enfermedad metabólica compleja, es ocasionada por un trastorno en la formación de la insulina (diabetes tipo I) o por un defecto en la captación celular de la glucosa (diabetes tipo II). Objetivo: determinar el espesor corneal en los pacientes diabéticos y no diabéticos Método: se realizó un estudio descriptivo transversal con el objetivo de determinar el espesor corneal en los pacientes diabéticos y no diabéticos, que acudieron al Centro Oftalmológico Carlos J Finlay, a la consulta de retina en el período de noviembre a diciembre de 2007. La muestra no probabilística fueron cincuenta pacientes que cumplían los criterios de inclusión, de los cuales treinta eran diabéticos (sesenta ojos) y veinte no diabéticos (cuarenta ojos). Se les aplicó un formulario para recoger los datos, los resultados se relacionaron con las siguientes variables: sexo, edad, tiempo de evolución de la enfermedad y espesor corneal. Se utilizó para medir el espesor corneal un paquímetro ultrasónico en cincuenta pacientes. Resultados: el mayor número de pacientes se encontró entre cuarenta y uno a sesenta años (veinticinco) pacientes, quince diabéticos y diez no diabéticos. El tiempo de evolución de la Diabetes que predominó fue el de once a veinte años con (veinte) pacientes, de ellos presentaron espesor corneal aumentado en veinte ojos derechos y dieciséis en ojos izquierdos. Los pacientes diabéticos tuvieron un espesor corneal aumentado en veinticinco ojos derechos y veinticuatro ojos izquierdos, el resto estuvo normal o disminuido, los no diabéticos se comportaron como disminuido o normal (AU)

Diabetes mellitus is a complex metabolic disease, it is caused by a disorder in the insulin formation (type I diabetes) or by a defect in the cellular uptake of glucose (type II diabetes). Objective: to determine the corneal thickness in diabetic and non-diabetic patients. Method: a cross-sectional descriptive study was carried out with the objective of determining the corneal thickness in diabetic and non-diabetics patients that came to the retina consultation at the Ophthalmological Center Carlos J Finlay, from November to December 2007. The non-probabilistic sample was fifty patients who completed the inclusion criteria, whom thirty were diabetic (sixty eyes) and twenty non-diabetics (forty eyes) patients. A form to pick up data were applied to them, results were related with the following variables: sex, age, time of evolution of the disease and corneal thickness. It was used to measure the corneal thickness an ultrasonic pachymeter in fifty patients. Results: the biggest number of patients was between forty-one to sixty years (twenty-five), fifteen diabetics and ten non-diabetics patients. The time of evolution of diabetes that prevailed was from eleven to twenty years with (twenty) patients, of them presented increased corneal thickness in twenty right eyes and sixteen in left eyes. Diabetic patients had an increased corneal thickness in twenty-five right eyes and twenty-four left eyes, the rest was normal or diminished, the non-diabetics behaved as diminished or normal (AU)

Resultados de la paquimetría ultrasónica en los pacientes diabéticos / Results of the ultrasonic pachymetry in diabetic patients

Fundamento: la Diabetes Mellitus es una enfermedad metabólica compleja, es ocasionada por un trastorno en la formación de la insulina (diabetes tipo I) o por un defecto en la captación celular de la glucosa (diabetes tipo II). Objetivo: determinar el espesor corneal en los pacientes diabéticos y no diabéticos Método: se realizó un estudio descriptivo transversal con el objetivo de determinar el espesor corneal en los pacientes diabéticos y no diabéticos, que acudieron al Centro Oftalmológico Carlos J Finlay, a la consulta de retina en el período de noviembre a diciembre de 2007. La muestra no probabilística fueron cincuenta pacientes que cumplían los criterios de inclusión, de los cuales treinta eran diabéticos (sesenta ojos) y veinte no diabéticos (cuarenta ojos). Se les aplicó un formulario para recoger los datos, los resultados se relacionaron con las siguientes variables: sexo, edad, tiempo de evolución de la enfermedad y espesor corneal. Se utilizó para medir el espesor corneal un paquímetro ultrasónico en cincuenta pacientes. Resultados: el mayor número de pacientes se encontró entre cuarenta y uno a sesenta años (veinticinco) pacientes, quince diabéticos y diez no diabéticos. El tiempo de evolución de la Diabetes que predominó fue el de once a veinte años con (veinte) pacientes, de ellos presentaron espesor corneal aumentado en veinte ojos derechos y dieciséis en ojos izquierdos. Los pacientes diabéticos tuvieron un espesor corneal aumentado en veinticinco ojos derechos y veinticuatro ojos izquierdos, el resto estuvo normal o disminuido, los no diabéticos se comportaron como disminuido o normal. Los pacientes masculinos se correspondieron con el mayor por ciento y a su vez con el espesor corneal aumentado. Conclusiones: los diabéticos estudiados tienen un espesor corneal por encima de quinientos cincuenta, los que tenían más de diez años de evolución tuvieron mayor espesor corneal, el sexo masculino presentó un adelgazamiento corneal, el mayor número de pacientes diabéticos están entre cuarenta y sesenta años. La raza blanca se correspondió con el mayor espesor corneal.

Background: diabetes mellitus is a complex metabolic disease, it is caused by a disorder in the insulin formation (type I diabetes) or by a defect in the cellular uptake of glucose (type II diabetes). Objective: to determine the corneal thickness in diabetic and non-diabetic patients. Method: a cross-sectional descriptive study was carried out with the objective of determining the corneal thickness in diabetic and non-diabetics patients that came to the retina consultation at the Ophthalmological Center Carlos J Finlay, from November to December 2007. The non-probabilistic sample was fifty patients who completed the inclusion criteria, whom thirty were diabetic (sixty eyes) and twenty non-diabetics (forty eyes) patients. A form to pick up data were applied to them, results were related with the following variables: sex, age, time of evolution of the disease and corneal thickness. It was used to measure the corneal thickness an ultrasonic pachymeter in fifty patients. Results: the biggest number of patients was between forty-one to sixty years (twenty-five), fifteen diabetics and ten non-diabetics patients. The time of evolution of diabetes that prevailed was from eleven to twenty years with (twenty) patients, of them presented increased corneal thickness in twenty right eyes and sixteen in left eyes. Diabetic patients had an increased corneal thickness in twenty-five right eyes and twenty-four left eyes, the rest was normal or diminished, the non-diabetics behaved as diminished or normal. Masculine patients correspond with the biggest percent and in turn with the increased corneal thickness. Conclusions: the studied diabetics have a corneal thickness above five-hundred and fifty, which had more than ten years of evolution, had bigger corneal thickness, masculine sex presented a corneal thinness, the biggest number of diabetic patients were between forty and sixty years. The white race corresponds to the biggest corneal thickness.

Relationship between visual field sensitivity loss and quadrantic macular thickness measured with Stratus-Optical coherence tomography in patients with chiasmal syndrome / Correlação entre defeito de campo visual e espessura macular quadrântica avaliada através da tomografia de coerência óptica em pacientes com compressão quiasmática

PURPOSE: To correlate visual field sensitivity (VFS) loss on standard automated perimetry (SAP) and quadrantic macular thickness on optical coherence tomography (OCT) in patients with permanent temporal hemianopia from chiasmal compression. METHODS: Forty eyes from 40 patients with chiasmal compression and 40 healthy eyes were submitted to standard automated perimetry and Stratus-OCT scanning. Raw data of the fast macular thickness scanning protocol were exported and macular thickness measurements were recorded and averaged for each quadrant and half of the central area. The correlation between visual field sensitivity loss and optical coherence tomography measurements was tested with Pearson's correlation coefficients and with linear regression analysis. RESULTS: A significant association was found between each macular thickness parameter and the corresponding central VF mean sensitivity. The strongest association was observed between superonasal macular thickness and the inferotemporal mean defect measured both in decibel (R=0.47; p=0.001) and in 1/Lambert (R=0.59; p<0.0001) units. CONCLUSION: Stratus-OCT-measured macular thickness was topographically related with visual field sensitivity loss in patients with temporal hemianopia from chiasmal compression. Such measurements could prove clinically useful in the diagnosis and follow-up of patients with chiasmal compression. ClinicalTrial.gov identifier number: NCT0039122.

OBJETIVO: Avaliar a correlação entre o defeito de campo visual ao exame de perimetria computadorizada e a espessura macular quadrântica ao exame de tomografia de coerência óptica (OCT) em pacientes com hemianopsia temporal permanente causada por compressão quiasmática. MÉTODOS: Quarenta olhos de 40 pacientes com compressão quiasmática e 40 olhos de 40 indivíduos controles foram submetidos aos exames de perimetria computadorizada e tomografia de coerência óptica. Dados não processados foram exportados e as medidas de espessura macular foram calculadas para cada quadrante e metade da área macular central. A correlação entre o defeito campimétrico e as medidas de espessura macular foi avaliada por coeficiente de correlação de Pearson e por análise de regressão linear. RESULTADOS: Associação significante foi encontrada entre os parâmetros de espessura macular e seus respectivos defeitos campimétricos. A correlação mais forte foi encontrada entre o parâmetro espessura macular nasal superior e o defeito campimétrico médio temporal inferior medido em decibel (R=0,47; p=0,001) e em 1/Lambert (R=0,59; p<0,0001). CONCLUSÃO: Medidas de espessura macular avaliada através da tomografia de coerência óptica foi topograficamente relacionada ao defeito campimétrico em pacientes com hemianopsia temporal por compressão quiasmática. Estas medidas podem provar a importância clínica no diagnóstico e seguimento dos pacientes com compressão quiasmática. ClinicalTrial.gov identifier number: NCT0039122.

Microperimetria y sensibilidad retiniana en pacientes operados con desprendimiento de retina / Microperimetry and retinal sensibility in patients operated by retinal detachment

La historia de la cirugía del desprendimiento de retina a estado siempre marcada por el misterio y los descalabros más estrepitosos, hasta los notables y revolucionarios aportes del retinólogo suizo Jules Gonin a principios del siglo XX. Objetivo: evaluar los resultados de la microperimetria en los pacientes operados por desprendimiento de retina. Método: se realizó un estudio longitudinal descriptivo transversal. El universo de estudio se constituyó por treinta y cinco pacientes diagnosticado por desprendimiento de retina en la consulta de oftalmología desde noviembre de 2008 a mayo de 2009. La muestra no probabilística la constituyeron veinte ojos, los cuales se escogieron mediante los criterios de selección establecidos, se les aplicó una encuesta y se estudiaron variables como: edad, sexo, tiempo de evolución, agudeza visual estabilidad y localización de la fijación, sensibilidad media y escotoma. Resultados: predominó el sexo masculino y las edades entre cuarenta y cinco y cincuenta años, el tiempo de evolución que predominó fue de un mes a dos meses, la agudeza visual fue de 20 /100 a los tres meses, la sensibilidad media más frecuente fue entre 20 y 7 dB entre 16 y 13 dB, la mayoría de los pacientes no presentaron escotoma central, la fijación que predominó fue estable y predominante central. Conclusiones: la sensibilidad media y la fijación no mostraron valores satisfactorios a los tres meses de operados los pacientes de desprendimiento de retina; la anatomía y las funciones de la retina no están totalmente recobradas a los tres meses de operados los pacientes (AU)

The history of retinal detachment surgery had always been marked by the mystery and the most boisterous misfortune, until the notables and revolutionaries contributions of the Swiss retinologist Jules Gonin at the beginning of the XX century. Objective: to evaluate the microperimetry results in patients operated by retinal detachment. Method: a cross-sectional, descriptive longitudinal study was conducted. The study universe was constituted by thirty-five patients diagnosed by retinal detachment in the ophthalmology consultation from November 2008 to May 2009. The non-probabilistic sample was constituted by twenty eyes, which were chosen by means of the established selection criteria; a survey was applied and variables like: age, sex, evolution time, visual acuity, stability and location of the fixation, medial sensibility and scotoma, were studied. Results: the male sex and the ages between forty-five and fifty years were the most frequent in the study, evolution time of detachment in the patients that prevailed was about one to two months, visual acuity was around 20/100 at the three months, the most frequent medial sensibility was between 20 and 7 dB between 16 and 13 dB, most of patients did not present central scotoma, the fixation that prevailed was stable and central predominant. Conclusions: medial sensibility and fixation did not show satisfactory values to the three months of having the patients operated of retinal detachment; anatomy and functions of the retina are not completely recovered in this period of time (AU)

Microperimetria y sensibilidad retiniana en pacientes operados con desprendimiento de retina / Microperimetry and retinal sensibility in patients operated by retinal detachment

Fundamento: la historia de la cirugía del desprendimiento de retina a estado siempre marcada por el misterio y los descalabros más estrepitosos, hasta los notables y revolucionarios aportes del retinólogo suizo Jules Gonin a principios del siglo XX. Objetivo: evaluar los resultados de la microperimetria en los pacientes operados por desprendimiento de retina. Método: se realizó un estudio longitudinal descriptivo transversal. El universo de estudio se constituyó por treinta y cinco pacientes diagnosticado por desprendimiento de retina en la consulta de oftalmología desde noviembre de 2008 a mayo de 2009. La muestra no probabilística la constituyeron veinte ojos, los cuales se escogieron mediante los criterios de selección establecidos, se les aplicó una encuesta y se estudiaron variables como: edad, sexo, tiempo de evolución, agudeza visual estabilidad y localización de la fijación, sensibilidad media y escotoma. Resultados: predominó el sexo masculino y las edades entre cuarenta y cinco y cincuenta años, el tiempo de evolución que predominó fue de un mes a dos meses, la agudeza visual fue de 20 /100 a los tres meses, la sensibilidad media más frecuente fue entre 20 y 7 dB entre 16 y 13 dB, la mayoría de los pacientes no presentaron escotoma central, la fijación que predominó fue estable y predominante central. Conclusiones: la sensibilidad media y la fijación no mostraron valores satisfactorios a los tres meses de operados los pacientes de desprendimiento de retina; la anatomía y las funciones de la retina no están totalmente recobradas a los tres meses de operados los pacientes.

boisterous misfortune, until the notables and revolutionaries contributions of the Swiss retinologist Jules Gonin at the beginning of the XX century. Objective: to evaluate the microperimetry results in patients operated by retinal detachment. Method: a cross-sectional, descriptive longitudinal study was conducted. The study universe was constituted by thirty-five patients diagnosed by retinal detachment in the ophthalmology consultation from November 2008 to May 2009. The non-probabilistic sample was constituted by twenty eyes, which were chosen by means of the established selection criteria; a survey was applied and variables like: age, sex, evolution time, visual acuity, stability and location of the fixation, medial sensibility and scotoma, were studied. Results: the male sex and the ages between forty-five and fifty years were the most frequent in the study, evolution time of detachment in the patients that prevailed was about one to two months, visual acuity was around 20/100 at the three months, the most frequent medial sensibility was between 20 and 7 dB between 16 and 13 dB, most of patients did not present central scotoma, the fixation that prevailed was stable and central predominant. Conclusions: medial sensibility and fixation did not show satisfactory values to the three months of having the patients operated of retinal detachment; anatomy and functions of the retina are not completely recovered in this period of time.

Avaliação do comportamento da pressão intraocular em pacientes com glaucoma primário de ângulo aberto assimétrico submetidos ao teste provocativo da ibopamina / Evaluation of the intraocular pressure behavior in patients with assimetric primary open-angle glaucoma submitted to ibopamine provocative test

OBJETIVO: Avaliar o efeito da ibopamina a 2 por cento tópica e comparar a variação na pressão intraocular (PIO) em olhos com glaucoma primário de ângulo aberto assimétrico (GPAA). MÉTODOS: Quinze pacientes (30 olhos) com GPAA com evolução assimétrica da neuropatia entre os dois olhos, onde comparamos em cada paciente a resposta a ibopamina e o defeito perimétrico, caracterizado por uma diferença de pelo menos 5dB de MD entre os olhos. O teste estatístico utilizado foi o t Student bicaudal e para significância estatística estabeleceu-se p <0,05. RESULTADOS: Em 80 por cento dos casos, (12/15 pacientes) o olho mais afetado pelo defeito perimétrico apresentou um aumento da PIO e/ou uma variaçã da PIO pós-ibopamina maior, sendo o resultado estatisticamente significativo (p<0,0001 e p = 0,0006), respectivamente. CONCLUSÃO: Este estudo mostrou que o defeito perimétrico no GPAA é significativamente relacionado com a positividade do teste de ibopamina sendo que olhos com maior defeito no campo visual apresentam maiores picos de PIO (max-PIO) pós-ibopamina e/ou uma maior variação em relação a sua PIO prévia ao teste (v-PIO).

OBJECTIVE: To evaluate the topic 2 percent ibopamine effect in the intraocular pressure (IOP) of eyes with assimetric primary open-angle glaucoma (POAG). METHODS: 15 patients (30 eyes) with primary open-angle glaucoma showing assimetric nerve disease evolution were assessed. We compared in all patients, the ibopamine response and the visual field defect between both eyes. The visual field, to be considered, should have at least 5 dB in MD difference between them. The statistical analysis was done with the Two-Tailed Student Test, with a Statistics significance of p<0.05. RESULTS: In 80 percent of the cases, (12/15 patients), the most affected eye in the visual field presented a greater variation and/or higher intraocular pressure after the ibopamine provocative test. The difference was statistically significant (p<0.00001 and p= 0.0006) respectively. CONCLUSION: This study showed that the visual field defect in GPAA is significantly connected with the positivity of the ibopamine test. The most affected eyes in the visual field presented a higher intraocular pressure (max-PIO) and/or a greater variation (v-PIO) after the ibopamine provocativetest.

The macular threshold protocol of the Humphrey visual field analyzer: a superior functional outcome of intravitreal bevacizumab for the treatment of neovascular age-related macular degeneration / Desfecho funcional superior da eficácia do tratamento com bevacizumab intravítreo em degeneração macular relacionada à idade, por meio do protocolo de limiar macular do campímetro de Humphrey

PURPOSE: To evaluate the decibel loss on the Macular threshold protocol of the Humphrey visual field as a reliable functional outcome of the intravitreal bevacizumab treatment. METHODS: Thirteen patients were evaluated at baseline and on the week 6 for best corrected visual acuity, optical coherence tomography central macular thickness and decibel loss on Macular threshold protocol of the Humphrey visual field after 1.25 mg intravitreal injection of bevacizumab. The outcomes were analyzed separately and in correlation using the Wilcoxon signed ranks test. RESULTS: The improvement of the optical coherence tomography and the Macular threshold protocol of the Humphrey visual field from baseline to week 6 were significant with p=0.032 and p=0.003, respectively. The visual acuity did not show a significant improvement. The correlation of the visual acuity and Macular threshold protocol of the Humphrey visual field was significant at baseline (p=0.041) and on week 6 (p=0.019). CONCLUSION: The Macular threshold protocol of the Humphrey visual field significantly improved despite the fact that the best corrected visual acuity did not. The Macular threshold protocol of the Humphrey visual field correlated with the visual acuities significantly. The optical coherence tomography was significant to demonstrate improvement but did not correlate with best corrected visual acuity and Macular threshold protocol of the Humphrey visual field. These findings suggest that the Macular threshold protocol of the visual field may be a more reliable tool for evaluation of global macular function after intravitreal bevacizumab treatment.

OBJETIVO: Avaliar se a perda de decibéis no protocolo macular do campímetro de Humphrey (PMCH) é um resultado funcional confiável para o tratamento com bevacizumab intravítreo. MÉTODOS: Treze pacientes foram avaliados na visita de base e na semana 6 após a injeção intravítrea de 1,25 mg de bevacizumab realizando a melhor acuidade visual corrigida, espessura macular central na tomografia de coerência óptica e análise da perda de decibéis no PMCH. Estes desfechos foram analisados separadamente e em correlação usando o teste Wicoxon signed ranks. RESULTADOS: A melhora da espessura central no OCT e do PMCH na semana 6 em relação a visita de base foi significante com p=0,032 e p=0,003 respectivamente. A acuidade visual não mostrou uma melhora estatisticamente significante. A correlação entre a acuidade visual e o PMCH foi significante na visita de base (p=0,041) e na visita de 6 semanas (p=0,019). CONCLUSÃO: O PMCH melhorou significantemente apesar do fato de que a melhor acuidade visual corrigida não apresentou tal melhora. O PMCH correlacionou-se com a acuidade visual de forma estatisticamente significativa. O OCT foi significativo para demonstrar melhora porém não se correlacionou com o PMCH e com a acuidade visual. Estes achados sugerem que o PMCH pode ser uma ferramenta mais confiável na avaliação da função macular global após injeção intravítrea de bevacizumab.

Correspondencia entre el tomógrafo retiniano de Heildelberg y la perimetría azul-amarillo en pacientes sospechosos de glaucoma / Correlation of Heidelberg´s retinal tomograph and blue-on-yellow perimetry in glaucoma-suspected patients

OBJETIVO: Valorar la correspondencia entre los resultados obtenidos con el tomógrafo retiniano de Heildelberg y la perimetría azul-amarillo en pacientes sospechosos de glaucoma. MÉTODOS: Se realizó un estudio descriptivo, prospectivo de corte longitudinal en 30 pacientes sospechosos de glaucoma, desde de noviembre de 2006 hasta abril de 2007. Se les realizaron tres exámenes topográficos de la papila óptica y tres exámenes perimétricos con un intervalo de 2 meses en un período de 6 meses. RESULTADOS: Predominó la edad mayor de 40 años (56,67 por ciento). Se observaron hallazgos topográficos sugestivos de glaucoma en un 63,3 por ciento de la muestra y fueron los más frecuentes: la excavación mayor de 0,6 en su eje vertical y el adelgazamiento del anillo neurorretiniano (56,67 por ciento en ambos casos). Aparecieron cambios perimétricos en 43,3 por ciento de los casos estudiados y los más frecuentes fueron en el primer estudio, el aumento de la mancha ciega y la pérdida general de la sensibilidad (10 por ciento). También estas manifestaciones fueron las más frecuentes en el segundo estudio (13,33 por ciento); el tercer estudio arrojó de forma similar una pérdida general de la sensibilidad en 43,33 por ciento de los pacientes. CONCLUSIONES: Los cambios topográficos precedieron en un mayor número de casos a los cambios perimétricos.

OBJECTIVE: To assess the correlation between the results achieved with the Heidelberg retinal tomography and the blue-on-yellow perimetry in glaucoma-suspected patients. METHODS: A prospective longitudinal and descriptive study was conducted on 30 glaucoma-suspected patients, from November 2006 to April 2007. Three topographic tests and three perimetric tests were performed on these patients in a 6-month period at 2- month intervals. RESULTS: Over 40 years of age prevailed (56,67 percent). Topographic findings indicative of glaucoma were observed in 63,3 percent of the sample and the most frequent were excavation higher than 0,6 in the vertical axis and the reduction of the neuroretinal ring (56,67 percent in both cases). Perimetric changes appeared in 43,3 percent in all the studied cases and the most common changes were increase of the blind spot and the general loss of sensitivity (10 percent) in the first study, and also in the second study (13,33 percent); the third study similarly yielded a general loss of sensitivity in 43,33 percent of patients. CONCLUSIONS: Topographic changes occurred before the perimetric changes in a high number of cases.

Does the apodized diffractive intraocular lens Acrysof ReSTOR NaturalTM interfere with FDT Matrix perimetry results? / A lente difrativa apodizada Acrysof ReSTOR NaturalTM pode interferir nos resultados da perimetria por FDT Matrix?

PURPOSE: To compare the effect of an apodized diffractive intraocular lens (IOL) (Acrysof ReSTOR NaturalTM) and its yellow counterpart (Natural IQ TM) on frequency doubling technology (FDT) perimetry results. METHODS: This study included 37 eyes from 22 patients at the "Centro Oftalmológico Tranjan" who had undergone uncomplicated phacoemulsification and intraocular lens implantation (17 Acrysof ReSTOR NaturalTM, 20 Natural IQ TM) performed by the same surgeon, at least three months prior to the study. Patients were subject to frequency doubling technology Matrix Perimeter testing. RESULTS: The patients were between 41 to 79 years old (mean, 70.78 ± 9.83) in the Natural IQ TM and 49 to 81 years old (mean, 67.11± 11.48) in the Acrysof ReSTOR NaturalTM group, and the mean IOP was 13.64 ± 2.02 mmHg in the Natural IQ TM 12.94 ± 1.39 mmHg in the Acrysof ReSTOR NaturalTM group. The mean pupillary diameter under scotopic conditions was 6.63 ± 1.16 mm in the Natural IQ TM group and 7.20 ± 1.8 mm in the Acrysof ReSTOR NaturalTM group (p=0.20). The mean deviation was -1.83 ± 3.46 dB in the Natural IQ TM group and -1.77 ± 3.94 dB in the Acrysof ReSTOR NaturalTM group (p=0.28). The pattern standard deviation was 3.49 ± 0.79 dB in the Natural IQ TM group and 3.20 ± 0.86 dB in the Acrysof ReSTOR NaturalTM group (p=0.27). CONCLUSION: There was no difference in the results of FDT Matrix perimetry in eyes that received apodized diffractive IOLs implant or eyes that received monofocal intraocular lens implant.

OBJETIVO: Comparar o efeito da lente difrativa apodizada (Acrysof ReSTOR NaturalTM) e da lente de mesma plataforma amarela (Natural IQ TM) sobre os resultados da perimetria de dupla frequência (FDT). MÉTODOS: O estudo incluiu 37 olhos de 22 pacientes do Centro Oftalmológico Tranjan que foram submetidos a cirurgia de facoemulsificação e implante de lentes intraoculares (17 Acrysof ReSTOR NaturalTM, 20 Natural IQ TM) sem complicações, realizadas pelo mesmo cirurgião, pelo menos três meses antes do estudo. Pacientes foram submetidos à perimetria FDT Matrix. RESULTADOS: A idade dos pacientes variou de 41 a 79 anos (média, 70,78 ± 9,83) no grupo Natural IQ TM e 49 a 81 anos (média, 67,11± 11,48) no grupo Acrysof ReSTOR NaturalTM , a PIO média foi 13,64 ± 2,02 mmHg no grupo Natural IQ TM e 12,94 ± 1,39 mmHg no grupo Acrysof ReSTOR NaturalTM. O diâmetro pupilar sobre condições escotópicas foi 6,63 ± 1,16 mm no grupo Natural IQ TM e 7,20 ± 1,8 mm no grupo Acrysof ReSTOR NaturalTM (p=0,20). O MD foi de -1,83 ± 3,46 dB no grupo Natural IQ TM e -1,77 ± 3,94 dB no grupo Acrysof ReSTOR NaturalTM (p=0,28). O PSD foi de 3,49 ± 0,79 dB no grupo Natural IQ TM e 3,20 ± 0,86 dB no grupo Acrysof ReSTOR NaturalTM (p=0,27). CONCLUSÃO: Não houve diferenças nos resultados da perimetria com FDT Matrix em olhos que receberam implante de lentes intraoculares difrativas apodizadas ou olhos que receberam LIOs monofocais.

Correspondencia entre el tomógrafo retiniano de Heildelberg y la perimetría azul-amarillo en pacientes sospechosos de glaucoma / Correlation of Heidelberg´s retinal tomograph and blue-on-yellow perimetry in glaucoma-suspected patients

OBJETIVO: Valorar la correspondencia entre los resultados obtenidos con el tomógrafo retiniano de Heildelberg y la perimetría azul-amarillo en pacientes sospechosos de glaucoma. MÉTODOS: Se realizó un estudio descriptivo, prospectivo de corte longitudinal en 30 pacientes sospechosos de glaucoma, desde de noviembre de 2006 hasta abril de 2007. Se les realizaron tres exámenes topográficos de la papila óptica y tres exámenes perimétricos con un intervalo de 2 meses en un período de 6 meses. RESULTADOS: Predominó la edad mayor de 40 años (56,67 por ciento). Se observaron hallazgos topográficos sugestivos de glaucoma en un 63,3 por ciento de la muestra y fueron los más frecuentes: la excavación mayor de 0,6 en su eje vertical y el adelgazamiento del anillo neurorretiniano (56,67 por ciento en ambos casos). Aparecieron cambios perimétricos en 43,3 por ciento de los casos estudiados y los más frecuentes fueron en el primer estudio, el aumento de la mancha ciega y la pérdida general de la sensibilidad (10 por ciento). También estas manifestaciones fueron las más frecuentes en el segundo estudio (13,33 por ciento); el tercer estudio arrojó de forma similar una pérdida general de la sensibilidad en 43,33 por ciento de los pacientes. CONCLUSIONES: Los cambios topográficos precedieron en un mayor número de casos a los cambios perimétricos(AU)

OBJECTIVE: To assess the correlation between the results achieved with the Heidelberg retinal tomography and the blue-on-yellow perimetry in glaucoma-suspected patients. METHODS: A prospective longitudinal and descriptive study was conducted on 30 glaucoma-suspected patients, from November 2006 to April 2007. Three topographic tests and three perimetric tests were performed on these patients in a 6-month period at 2- month intervals. RESULTS: Over 40 years of age prevailed (56,67 percent). Topographic findings indicative of glaucoma were observed in 63,3 percent of the sample and the most frequent were excavation higher than 0,6 in the vertical axis and the reduction of the neuroretinal ring (56,67 percent in both cases). Perimetric changes appeared in 43,3 percent in all the studied cases and the most common changes were increase of the blind spot and the general loss of sensitivity (10 percent) in the first study, and also in the second study (13,33 percent); the third study similarly yielded a general loss of sensitivity in 43,33 percent of patients. CONCLUSIONS: Topographic changes occurred before the perimetric changes in a high number of cases(AU)

Efeitos da ibopamina 2 por cento tópica nos resultados da campimetria visual computadorizada / Effects of 2 percent ibopamine eye drops on computerized visual field results

OBJETIVO: Avaliar os efeitos do uso do colírio de ibopamina a 2 por cento nos resultados da campimetria visual computadorizada em indivíduos normais. MÉTODOS: Voluntários oriundos do CEROF-UFG, sem alterações ao exame oftalmológico que pudessem afetar o campo visual foram selecionados. Os indivíduos foram submetidos a exame de perimetria computadorizada SITA-standard 24-2 antes e após dilatação com o colírio de ibopamina a 2 por cento ou ciclopentolato, com intervalo mínimo de 3 dias entre si e em ordem aleatória. Índices globais e número de pontos alterados foram comparados entre os grupos. RESULTADOS: Foram avaliados 30 olhos de 30 indivíduos normais. Não houve diferença estatisticamente significativa entre o "mean deviation" (MD) nos pacientes não dilatados e nos mesmos após a instilação da ibopamina (MD: -1,05 ± 0,26 dB vs. -1,47 ± 0,20 dB, P=0,08), o que ocorreu após cicloplegia (MD: -3,19 ± 0,29 dB), P<0,001 para ambos. Na avaliação entre cicloplegia e pré-dilatação, nota-se significância para o "pattern standard deviation" (P=0,04), o que não ocorreu na avaliação com ibopamina. O número de pontos alterados no "pattern deviation" não apresentou diferença significativa entre todos os pares. Quanto ao número de pontos do "total deviation", houve diferença estatisticamente significativa antes da dilatação e após o uso do cicloplégico (n: 8,86 ± 1,51 vs. 25,72 ± 2,96 pontos, P<0,001) e entre olhos após a instilação do cicloplégico e da ibopamina (ibopamina: 9,75 ± 1,85 pontos, P<001). CONCLUSÃO: O colírio de ibopamina 2 por cento aparentemente não afeta os resultados da perimetria computadorizada em indivíduos normais.

PURPOSE: To evaluate the influence of 2 percent ibopamine eye drops on the results of computerized visual field exams. METHODS: Normal volunteers from CEROF-UFG were selected, with no variance in the ophthalmologic examination that could affect the visual field test. The volunteers underwent computerized visual field test before and after dilation with 2 percent ibopamine eye drop or cyclopentolate, with a minimum interval of three days between them and in a random order. Global indices and number of altered points were compared between the groups. RESULTS: Thirty eyes of 30 normal individuals were selected. There was no statistically significant difference on Mean Deviation (MD) before and after dilation with ibopamine (MD: -1.05 ± 0.26 dB vs. -1.47 ± 0.20 dB, P=0.08). However, after cycloplegia (MD: -3.19 ± 0.29 dB), there was a significant difference on MD (P<0.001 for both ibopamine and pre-dilation). No significant difference was detected in the Pattern Standard Deviation when comparing ibopamine with pre-dilation and cycloplegia values, but it was statistically significant comparing pre-dilation to cycloplegia (P=0.04). The number of altered points in the Pattern Deviation graphic were not significant comparing all pairs. There was a statistically significant difference in the number of altered points in the total deviation graphic before dilation and after cycloplegia (n: 8.86 ± 1.51 vs. 25.72 ± 2.96 points, P<0.001), and comparing cycloplegia with ibopamine (ibopamine: 9.75 ± 1.85 points, P<0.001). CONCLUSION: Ibopamine 2 percent eye drops seem to not modify the results of visual field tests in normal individuals.

Learning effect of standard automated perimetry in healthy individuals / Efeito aprendizado da perimetria automática padrão em indivíduos saudáveis

PURPOSE: To evaluate the learning effect in standard automated perimetry using SITA strategy, central 24-2 program, possible associated factors and spatial distribution in individuals with no perimetry experience. METHODS: A total of 55 healthy subjects were submitted to Humphrey perimetry in two different sessions in one day. Reliability and global indices, and threshold sensitivity at each point were compared between the two examinations. The influence of potential factors (age, gender, and educational level) and the spatial distribution were evaluated regarding alterations between these two examinations. RESULTS: The duration of the test was longer in the first session (median, 5.7 min; interquartile range [IQR], 1.7 min) than in the second (median, 5.3; IQR, 1.1 min) (p=0.002). The median (IQR) of false negative errors was 2 percent (6 percent) in the first examination and 0 percent (6 percent) in the second (p=0.04). The mean (standard deviation) in the mean deviation (MD) global index was -2.31 (1.86) dB in the first examination and -1.73 (1.69) dB in the second (p=0.07). No association was observed between the change in MD and age (p=0.29), gender (p=0.69) and educational level (p=0.27). The changes in threshold sensitivity were greater at the peripheral points than at the central points (p<0.001). CONCLUSION: The threshold sensitivity increased in the second examination compared to the first. No factors were associated with this change. The changes in threshold sensitivity were more evident at the peripheral points.

OBJETIVO: Avaliar o efeito aprendizado da perimetria automatizada padrão com a estratégia SITA, programa central 24-2, possíveis fatores associados e distribuição espacial em indivíduos inexperientes em perimetria. MÉTODOS: Um total de 55 indivíduos saudáveis foi submetido a exame de perimetria com aparelho Humphrey em duas sessões no mesmo dia. Foram comparados os índices de confiabilidade, globais e limiares de sensibilidade de cada ponto entre os exames. Foram analisados potenciais fatores relacionados (idade, sexo e nível educacional), bem como a distribuição espacial em relação à alteração entre os exames. RESULTADOS: A duração do exame foi maior na primeira sessão (mediana, 5,7 min; amplitude interquartil [AIQ], 1,7 min) do que na segunda (mediana, 5,3; AIQ, 1,1 min) (p=0,002). A mediana (AIQ) da taxa de falsos negativos foi 2 por cento (6 por cento) no primeiro exame e 0 por cento (4 por cento) no segundo exame (p=0,04). A média (desvio padrão) do índice global desvio médio (MD) foi -2,31 (1,86) dB no primeiro exame e -1,73 (1,69) dB no segundo exame (p=0,007). Não houve associação entre a mudança do MD em relação à idade (p=0,29), sexo (p=0,69) e nível de escolaridade (p=0,27). Houve maior alteração na sensibilidade dos pontos periféricos em relação aos pontos centrais (p<0,001). CONCLUSÃO: Houve melhora dos limiares de sensibilidade entre o primeiro e segundo exames. Não foram detectados fatores associados a estas mudanças. Nos pontos mais periféricos do exame, tais mudanças foram mais acentuadas.