Achromatic and short-wavelength automated perimetry in patients with glaucomatous large cups

Citation
Sl. Mansberger et al., Achromatic and short-wavelength automated perimetry in patients with glaucomatous large cups, ARCH OPHTH, 117(11), 1999, pp. 1473-1477
Citations number
30
Categorie Soggetti
Optalmology,"da verificare
Journal title
ARCHIVES OF OPHTHALMOLOGY
ISSN journal
00039950 → ACNP
Volume
117
Issue
11
Year of publication
1999
Pages
1473 - 1477
Database
ISI
SICI code
0003-9950(199911)117:11<1473:AASAPI>2.0.ZU;2-5
Abstract
Objective: To evaluate visual function and optic disc features in patients with large cup-disc ratios (C/Ds). Methods: One eye of 86 patients with vertical C/Ds by contour of at least 0 .8, who had undergone both standard achromatic automated perimetry (SAP) an d short-wavelength automated perimetry (SWAP) testing, was selected retrosp ectively. Two masked glaucoma specialists independently graded stereoscopic photographs for vertical C/Ds, rim thinning, notching, excavation, optic d isc hemorrhages, and nerve fiber layer defects. Visual fields ere classifie d as abnormal if the glaucoma hemifield test result, corrected pattern stan dard deviation, or mean deviation uas outside age-specific normal limits. C onfocal scanning laser ophthalmoscopy was used to determine disc area. Results: SAP and SWAP results were abnormal in 44 (51%) and 52 (60%) of 86 patients, respectively. In patients with normal SAP results, SWAP results w ere abnormal in 14 (33%) of 42 patients. In patients with normal SWAP resul ts, SAP results were abnormal in 6 (18%) of 34 patients. Small discs are as sociated with an abnormal SAP result (P=.01) and an abnormal SWAP result (P =.09). An increased vertical C/D greater than the qualifying level of 0.8 w as associated with an abnormal SAP or SWAP result (P less than or equal to. 001). Rim thinning (P=.01) and disc hemorrhages (P=.04) were associated wit h an abnormal SAP result. Conclusions: Many patients with large C/Ds have normal SAP and SWAP results . Compared with SAP, SWAP results were abnormal in a higher percentage of t hese patients. If a patient has a large C/D and normal SAP results, SWAP te sting may detect functional loss earlier. If glaucoma is defined by both st ructural and functional loss, patients with large vertical C/Ds, normal SAP results, and abnormal SWAP results may have glaucoma. Longitudinal studies are needed to assess this hypothesis and determine whether these patients subsequently develop abnormal SAP results as well.