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Axis X, Y (parallel to the sea level) Axis Z (perpendicular to the sea level)
The visual field is measured in two ways Kinetic and Static perimetry
Definition of threshold
Threshold sensitivity is defined as the stimulus intensity at which the patient respond 50% of the time
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Zone 1 : Patient and Test Data Patient name and identity number Age and date of birth
Wrong patients age can alter results of field test
Eye tested Visual acuity and refractive correction used Pupillary size
Pupillary size should remain constant in follow up fields
Reliability parameter Unreliable .XX Patient Fixation > 20% False Positive errors > 33% False negative errors > 33%
False positive > 33% gray scale : white scotoma GHT : abnormaly high sensitivity False negative >33% lack of attentive, fatique, advance damage
Low patient reliability does not necessarily mean lack useful information It is just that such field are not included in the database, such field must be interpreted with more caution.
Useful when there are Gross False positive (white scotoma) False negative error (clover leaf) Explain the seriousness of the condition to the patient
Paracentral Scotoma
Arcuate Scotoma
Temporal Wedge
Nasal Step
numeric values
probability plot
Generalized depression (cataract) Zone 4: many depressed point Zone 5: normal No localized defect
(courtesy of Prof. Ravi Thomas)
Localized scotoma
Each global index summarized and characterizes one aspect of the test as a single value
Hoddap Classification
Early Glaucomatous Loss
a. MD > -6 dB b. Fewer than 18 points depressed below the 5% probability level and fewer than 10 points below the p<1% level c. No point in the central 5 degrees with a sensitivity of less than 15 dB
Hoddap Classification
Moderate Glaucomatous Loss
a. -6>MD > -12 dB b. Fewer than 37 points depressed below the 5% probability level and fewer than 20 points below the p<1% level c. No absolute deficit (0 dB) in the 5 central degrees d. Only one hemifield with sensitivity of < 15 dB in the 5 central degrees
Hoddap Classification
Advanced Glaucomatous Loss
a. MD < -12 dB b. More than 37 points depressed below the 5% probability level or more than 20 points below the p<1% level c. Absolute deficity (0 dB) in the 5 central degrees d. Sensitivity < 15 dB in the 5 central degrees in both hemifields
Five possible message of GHT Outside normal limit Borderline General reduction of sensitivity Abnormally high sensitivity Within normal limits
Five zones in the upper field are compared its mirror-image in the lower field
Early glaucoma:
1.Pattern deviation probability plot shows a cluster of > 3 non-edge points with p< 5% and one points has p<1%.
FIGURE 2 : HFA 30-2 of the same patient as in figure 1 with the field repeated with an appropriate contact lens
CASE 1
CASE 2
Zone 1 and 2: Ok Zone 3 : arcuate defect Zone 4 : depressed point superiorly Zone 5 : arcuate scotoma Zone 6: MD and PSD abnormal Zone 7: GHT outside normal limits It is consistent with typical glaucomatous defect Then correlate with fundus finding
CASE 2
Inferior retinochoroid coloboma
Case 3
Zone 1: 30-2 program
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