Amf. Wong et Ja. Sharpe, A comparison of tangent screen, Goldmann, and Humphrey perimetry in the detection and localization of occipital lesions, OPHTHALMOL, 107(3), 2000, pp. 527-544
Objective: To compare manual kinetic perimetry with tangent screen and Gold
mann techniques and automated static perimetry with the Humphrey Field Anal
yzer in the detection and localization of occipital lobe lesions.
Design: Prospective consecutive comparative case series,
Participants: Twelve patients with well-defined occipital lobe infarcts on
magnetic resonance (MR) imaging were studied.
Main Outcome Measures: The patients were tested by tangent screen, Goldmann
, and Humphrey perimetry (central 30-2 threshold program). The three visual
fields were compared and correlated with MR images.
Results: All three perimetric techniques detected the presence of postchias
mal lesions. However, localization of lesions differed with perimetric tech
nique. Visual fields obtained from tangent screen and Goldmann perimetry we
re similar and corresponded well with the location of lesions on MR images
in all 12 patients, Humphrey perimetry inaccurately localized the lesion to
the proximal part of the postchiasmal pathway by revealing incongruous fie
lds in two patients, failed to detect sparing of the posterior occipital co
rtex or occipital pole in four patients, and estimated a larger extent of d
amage in one patient when compared with MR images and manual perimetry,
Conclusions: All three perimetric techniques are satisfactory screening tes
ts to detect occipital lesions. However, tangent screen and Goldmann perime
try provide information about the location and extent of lesions that is mo
re consistent with prevailing knowledge of the effects of the lesion in the
postgeniculate visual pathway, (C) 2000 by the American Academy of Ophthal
mology.