Perimetry, the evaluation of the visual field, is an important diagnostic test not only in glaucoma, but also for diagnosing and monitoring the progression of many other eye diseases. In routine perimetry, computer supported static perimetry, as it was introduced in 1975 by Fankhauser, proved to be more practical compared to the traditional manual Goldmann method. However, in special situations including neuroophthalmology, it is important to have information about the peripheral visual field. Therefore, in end stage of glaucoma and in cases with patients having difficulty collaborating with an automatic test, computer- assisted (semi-automatic) kinetic testing continues to play an important role in testing the visual field.
1- Stimulus Variables
1. Step-wise threshold approach
2- Testing Strategies
1. SITA, SITA-FAST, etc
3- Evaluating Reliability
1. Fixation Losses
2. False Positives – “Trigger Happy”
3. False Negatives – Status of eye, not pt
4- Visual Field Indices
1. MD and PSD
5- Glaucoma Hemifield Test
6- Total and Pattern Deviation
1. Numeric and Probability Plots
7- Common glaucoma visual field patterns
8- Judging visual field progression
1. No widely accepted standard
a) Deepening or expansion of an existing scotoma
b) Major challenges
2. Short-term vs. long-term fluctuations, trend analysis, etc
3. Considerations for treatment
4. Visual Field Index (VFI)
a) Method of calculating VFI
b) Resistant to cataract
c) Used to judge rate of progression
5. Guided (or Glaucoma) Progression Analysis (GPA)
a) Newer software to help calculate rate of progression from VFI
6. How many VFs are needed?
a) OHTS vs. HAP vs. clinical trials
b) Confirming progression
c) Repeatability, reliability, clinical trials data
d) Progression definitions
9- Other visual fields - FDT, FDT Matrix and Sita SWAP