Purpose: We evaluated the clinical usefulness of flicker perimetry in glaucoma and glaucoma suspect patients using the new Octopus 311 automated perimeter. Methods: A total of 52 eyes of 52 glaucoma patients, 26 eyes ...Purpose: We evaluated the clinical usefulness of flicker perimetry in glaucoma and glaucoma suspect patients using the new Octopus 311 automated perimeter. Methods: A total of 52 eyes of 52 glaucoma patients, 26 eyes of 26 glaucoma suspect patients and 61 eyes of 61 normal subjects were examined using standard automated perimetry (SAP), flicker perimetry and frequency doubling technology (FDT) perimetry. Flicker perimetry was performed using the Octopus 311 and its remote software package. Suprathreshold four-zone probability strategy was used to classify the critical fusion frequency probability level. The classified levels were set at 5% and 1% of probability of normality and 5 Hz. Frequency doubling technology perimetry was performed using 24- 2- 5, 24- 2- 1,N- 30- 5, N- 30- 1 screening programs using Humphrey Matrix perimetry. Standard automated perimetry was performed using the Humphrey field analyser program 24- 2 full threshold. Optical coherence tomography using Stratus OCT was used for evaluating the retinal nerve fibre layer thickness in all glaucoma and glaucoma suspect patients. Results: Receiver operating characteristic (ROC) curves were calculated. In the early stage of glaucoma, the areas under the ROC curve (AUCs) were 0.96 in flicker and 0.90 in Matrix perimetry. In the moderate and advanced stages of glaucoma, the AUCs were almost 1.0 in all tests. In glaucoma suspect patients, the AUC of the 5% probability level in flicker was significantly higher than in Matrix perimetry. Conclusion: The four-zone probability strategy using the Octopus 311 is a useful method for evaluating the flicker field in early glaucoma and glaucoma suspect patients.展开更多
Objectives:To create a fully automated,combined perimetry program consisting of a static examination and a kinetic examination,and to compare the results of this test with standard static and kinetic visual fields(VFs...Objectives:To create a fully automated,combined perimetry program consisting of a static examination and a kinetic examination,and to compare the results of this test with standard static and kinetic visual fields(VFs).Methods:Fifty-six patients(74 eyes)undergoing neuroophthalmic or glaucoma evaluationwho had standard static or kinetic perimetry examinations underwent the combined perimetry test.This automated,combined test,performed on the Octopus 101 perimeter,consisted of a static tendency-oriented perimetry examination and a preprogrammed kinetic examination.Three masked physician reviewers independently classified all of the VFs.The VF pairs were considered a match if the consensus descriptions of the standard and combined VFs matched.Results:Thirty seven eyes underwent evaluation for neuroophthalmic disease(comparison standard test,20 static and 17 kinetic)and 37 for glaucoma(comparison standard test,17 static and 20 kinetic).The VP pairs matched in 32 eyes(86%)in the neuroophthalmic group and 28(76%)in the glaucoma group.On inspection by a fourth reviewer,many of the nonmatching VF pairs were those for which a consensus was not reached,but still conveyed similar information.Two glaucomatous eyes demonstrated central scotomata not delineated by the combined examination findings.Two subtle nasal steps were detected solely by the combined examination.The combined test ranged in time from 6 to 12 minutes per eye.Conclusions:The Octopus 101 perimeter can be used to create an automated test that combines the advantages of static and kinetic perimetry and produces equivalent results while not requiring examiner expertise.展开更多
Objective: The European Glaucoma Prevention Study (EGPS)- seeks to evaluate the efficacy of reduction of intraocular pressure (IOP) by dorzolamide in preventing or delaying primary open- angle glaucoma (POAG) in patie...Objective: The European Glaucoma Prevention Study (EGPS)- seeks to evaluate the efficacy of reduction of intraocular pressure (IOP) by dorzolamide in preventing or delaying primary open- angle glaucoma (POAG) in patients affected by ocular hypertension (OHT). Design: Randomized, doublemasked, controlled clinical trial. Participants: One thousand eighty- one patients (age,< 30 years) were enrolled by 18 European centers. The patients fulfilled a series of inclusion criteria, including: IOP 22 to 29 mmHg; 2 normal and reliable visual fields (on the basis of mean deviation and corrected pattern standard deviation or corrected loss variance of standard 30/II Humphrey or Octopus perimetry); normal optic disc as determined by the Optic Disc ReadingCenter. Intervention: Patients were randomized to treatment with dorzolamide or placebo (the vehicle of dorzolamide). Main Outcome Measures: Efficacy end points were visual field, optic disc changes, or both. A visual field change during follow- up had to be confirmed by 2 further positive tests. Optic disc changewas defined on the basis of the agreement of 2 of 3 independent observers evaluating optic disc stereo slides. The safety end point was an IOP of more than 35 mmHg on 2 consecutive examinations. Results: During the course of the study, the mean percent reduction in IOP in the dorzolamide group was 15% after 6 months and 22% after 5 years. Mean IOP declined by 9% after 6 months and by 19% after5 years in the placebo group. At 60 months, the cumulative probability of converting to an efficacy end point was 13.4% in the dorzolamide group and 14.1% in the placebo group (hazard ratio, 0.86; 95% confidence interval [CI], 0.58- 1.26; P=0.45). The cumulative probability of developing an efficacy or a safety end point was 13.7% in the dorzolamide group and 16.4% in the placebo group (hazard ratio, 0.73; 95% CI, 0.51- 1.06; P=0.1). Results: Dorzolamide reduced IOP by 15% to 22% throughout the 5 years of the trial. However, the EGPS failed to detect a statistically significant difference between medical therapy and placebo in reducing the incidence of POAG among a large population of OHT patients atmoderate risk for developing POAG, because placebo also significantly and consistently lowered IOP.展开更多
文摘Purpose: We evaluated the clinical usefulness of flicker perimetry in glaucoma and glaucoma suspect patients using the new Octopus 311 automated perimeter. Methods: A total of 52 eyes of 52 glaucoma patients, 26 eyes of 26 glaucoma suspect patients and 61 eyes of 61 normal subjects were examined using standard automated perimetry (SAP), flicker perimetry and frequency doubling technology (FDT) perimetry. Flicker perimetry was performed using the Octopus 311 and its remote software package. Suprathreshold four-zone probability strategy was used to classify the critical fusion frequency probability level. The classified levels were set at 5% and 1% of probability of normality and 5 Hz. Frequency doubling technology perimetry was performed using 24- 2- 5, 24- 2- 1,N- 30- 5, N- 30- 1 screening programs using Humphrey Matrix perimetry. Standard automated perimetry was performed using the Humphrey field analyser program 24- 2 full threshold. Optical coherence tomography using Stratus OCT was used for evaluating the retinal nerve fibre layer thickness in all glaucoma and glaucoma suspect patients. Results: Receiver operating characteristic (ROC) curves were calculated. In the early stage of glaucoma, the areas under the ROC curve (AUCs) were 0.96 in flicker and 0.90 in Matrix perimetry. In the moderate and advanced stages of glaucoma, the AUCs were almost 1.0 in all tests. In glaucoma suspect patients, the AUC of the 5% probability level in flicker was significantly higher than in Matrix perimetry. Conclusion: The four-zone probability strategy using the Octopus 311 is a useful method for evaluating the flicker field in early glaucoma and glaucoma suspect patients.
文摘Objectives:To create a fully automated,combined perimetry program consisting of a static examination and a kinetic examination,and to compare the results of this test with standard static and kinetic visual fields(VFs).Methods:Fifty-six patients(74 eyes)undergoing neuroophthalmic or glaucoma evaluationwho had standard static or kinetic perimetry examinations underwent the combined perimetry test.This automated,combined test,performed on the Octopus 101 perimeter,consisted of a static tendency-oriented perimetry examination and a preprogrammed kinetic examination.Three masked physician reviewers independently classified all of the VFs.The VF pairs were considered a match if the consensus descriptions of the standard and combined VFs matched.Results:Thirty seven eyes underwent evaluation for neuroophthalmic disease(comparison standard test,20 static and 17 kinetic)and 37 for glaucoma(comparison standard test,17 static and 20 kinetic).The VP pairs matched in 32 eyes(86%)in the neuroophthalmic group and 28(76%)in the glaucoma group.On inspection by a fourth reviewer,many of the nonmatching VF pairs were those for which a consensus was not reached,but still conveyed similar information.Two glaucomatous eyes demonstrated central scotomata not delineated by the combined examination findings.Two subtle nasal steps were detected solely by the combined examination.The combined test ranged in time from 6 to 12 minutes per eye.Conclusions:The Octopus 101 perimeter can be used to create an automated test that combines the advantages of static and kinetic perimetry and produces equivalent results while not requiring examiner expertise.
文摘Objective: The European Glaucoma Prevention Study (EGPS)- seeks to evaluate the efficacy of reduction of intraocular pressure (IOP) by dorzolamide in preventing or delaying primary open- angle glaucoma (POAG) in patients affected by ocular hypertension (OHT). Design: Randomized, doublemasked, controlled clinical trial. Participants: One thousand eighty- one patients (age,< 30 years) were enrolled by 18 European centers. The patients fulfilled a series of inclusion criteria, including: IOP 22 to 29 mmHg; 2 normal and reliable visual fields (on the basis of mean deviation and corrected pattern standard deviation or corrected loss variance of standard 30/II Humphrey or Octopus perimetry); normal optic disc as determined by the Optic Disc ReadingCenter. Intervention: Patients were randomized to treatment with dorzolamide or placebo (the vehicle of dorzolamide). Main Outcome Measures: Efficacy end points were visual field, optic disc changes, or both. A visual field change during follow- up had to be confirmed by 2 further positive tests. Optic disc changewas defined on the basis of the agreement of 2 of 3 independent observers evaluating optic disc stereo slides. The safety end point was an IOP of more than 35 mmHg on 2 consecutive examinations. Results: During the course of the study, the mean percent reduction in IOP in the dorzolamide group was 15% after 6 months and 22% after 5 years. Mean IOP declined by 9% after 6 months and by 19% after5 years in the placebo group. At 60 months, the cumulative probability of converting to an efficacy end point was 13.4% in the dorzolamide group and 14.1% in the placebo group (hazard ratio, 0.86; 95% confidence interval [CI], 0.58- 1.26; P=0.45). The cumulative probability of developing an efficacy or a safety end point was 13.7% in the dorzolamide group and 16.4% in the placebo group (hazard ratio, 0.73; 95% CI, 0.51- 1.06; P=0.1). Results: Dorzolamide reduced IOP by 15% to 22% throughout the 5 years of the trial. However, the EGPS failed to detect a statistically significant difference between medical therapy and placebo in reducing the incidence of POAG among a large population of OHT patients atmoderate risk for developing POAG, because placebo also significantly and consistently lowered IOP.
