SHORT-WAVELENGTH AUTOMATED PERIMETRY IN NEUROOPHTHALMOLOGICAL DISORDERS

Objective: To evaluate the efficacy of short-wavelength automated peri metry (SWAP) in the assessment of patients with neuro-ophthalmologic d isorders, especially optic neuropathies. Methods: A modified Humphrey field analyzer was used to perform standard automated perimetry and SW AP, a technique that isolates the activity of short-wavelength-sensiti ve (''blue'') mechanisms. Forty patients (80 eyes) were evaluated by S WAP and standard automated perimetry. Thirteen patients (26 eyes) had recovered from optic neuritis and/or multiple sclerosis, 15 (30 eyes) were in various stages of treatment for pseudotumor cerebri, and 12 (2 4 eyes) had other miscellaneous neuro-ophthalmologic conditions. Six a dditional patients (12 eyes) with neuro-ophthalmologic conditions were tested twice on different days during a 2-week period, with the order of SWAP and standard perimetric testing being reversed on the second day. Results: Of the 80 eyes tested, 38 (48%) had SWAP visual fields t hat were worse than standard automated perimetry results; 29 (36%) sho wed no difference between standard and SWAP visual fields; and 13 (16% ) had standard automated perimetry results that were worse than SWAP v isual fields. Of the 26 eyes in patients with optic neuritis and/or mu ltiple sclerosis, 15 (58%) had SWAP results that were worse than stand ard visual fields. Ten (33%) of the 30 eyes with pseudotumor cerebri h ad SWAP results worse than standard automated perimetry results, and 1 3 (54%) of 24 eyes with miscellaneous neuro-ophthalmologic conditions had SWAP results worse than standard automated perimetry results. For the 12 eyes undergoing repeated testing, SWAP visual fields were worse when they were performed last, perhaps indicating that some fatigue e ffect was present. This was observed for standard visual fields as wel l, but to a smaller extent. Conclusions: Preliminary findings suggest that SWAP may be useful in detecting certain neuro-ophthalmologic defi cits more readily than standard automated visual field testing, especi ally for optic neuritis and multiple sclerosis. Further evaluations wi ll be necessary to define the effects of fatigue for SWAP visual field s in neuro-ophthalmologic disorders.