Objective To evaluate the application of tendency-oriented perimetry (TOP) in detecting the visual function of glaucoma. Methods The traditional threshold perimetry (Normal/Normal strategy) and TOP (TOP/Normal strategy) carried out by Octopus 101 perimetry were used to examine the visual field of 20 normal subjects (20 eyes), 32 cases (32 eyes) of primary open-angle glaucoma (POAG), and 14 cases (14 eyes) of suspected POAG, respectively. The visual field outcomes, indices, point by point threshold variability and defective points of the two perimetries were compared and analysed. Results The negative rate of TOP was 90% in normal subjects. The positive rate of TOP was 75% in POAG , and 100% in middle and late stage of POAG. The visual field indices of two perimetries were positively correlated, with mean sensitivity (MS) of r=0.9335, mean defect (MD) of r=0.9189, and loss variance (LV) of r=0.9621. The point by point threshold variability and defective points of TOP were higher than those of traditional threshold perimetry, but the difference between the two perimetries was not significant (P=0.2019, P=0.4448). Conclusion The visual field indices of TOP and traditional threshold perimetry are positively correlated. The sensitivity and reproducibility of TOP are high in detecting the visual function of middle and late stage of POAG. (Chin J Ocul Fundus,Dis, 2002, 18: 269-272)
PURPOSE:To approach the changes of visual function by using the dense matrix mapping in macula(DMMM)in patients with age-related macular degenerationl(AMD). METHODS:The DMMM was designed using Humphrey-640,thee study included 51 patients(71 eyes)in dry type,AMD,23 patients(27 eyes)in wet type and 16 normal elderly(21 eyes). RESULTS:In 2.5 degree of macula:the mean light sensitivity(MLS)was 35.61plusmn;1.37 in normal elderly.33.30plusmn;2. 49 in dry type group and 20.67plusmn;8.30 in wet type group,and differences were highly significant statistically among them. In S degree the MLS is 34.93plusmn;1.46 in normal elderly.32.95plusmn;1.82 in dry type group, 22.11plusmn;7.74 in wet type group ,and the differences were highly significant statistically among them. CONCLUSIONS:The MLS of DMMM declined at early stage of dry type AMD and there was relatively high sensitivity of MLS of DMMM in evaluating the visual function in early AMD. （Chin J Ocul Fundus Dis,1996,12: 217-219 ）
Objective To evaluate the diagnosis of blue-on-yellow perimetry and macular threshold perimetry in early primary glaucoma. Methods Humphrey II 750 automatic perimetry was used to test 60 eyes of 60 cases in normal control group and 63 eyes of 63 cases in early primary glaucoma group with white-on-white perimetry (W/W), blue-on-yellow perimetry (B/Y)，and macular threshold perimetry (M TP). The results of the visual field defects detected by the three perimetries were compared and analyzed.Results The differences of mean sensibility of W/W, B/Y and MTP between the two groups had statistical significance［t=-3 .01, P=0.0054 (W/W); t=-2.95, P=0.006 3 (B/Y); t=-2.59,P=0. 0150 (MTP)］. In the diagnosis of early primary glaucoma, the sensitivity of MTP was the highest (83%), B/Y was the second (65%), and W/W was the lowest (48%). When B/Y and MTP were combined, the sensitivity was improved to 94% using parallel testing, and the specificity was improved to 87% using serial testing.Conclusions B/Y and MTP are valuable in diagnosis of early primary glaucoma, and the sensitivity and specificity of the diagnosis can be improved when B/Y and MTP are combined. (Chin J Ocul Fundus Dis，2003，19：102-105)
Objective To determine the correlation between central macular thickness (CMT) and the visual function in patients iwht macular edema (ME). Methods The clinical data of 42 eyes of 40 patients with ME which were examined by optical coherence tomography (OCT) and microperimetry (MP-1) were retrospectively analyzed. In 40 patients (42 eyes), diabetic ME (DME) was in 27 eyes，branch retinal vein occlusion was in 11eyes, and central retinal vein occlusion was in 4 eyes. All of the eyes had undergone OCT，MP-1 and best-corrected visual acuity (BCVA) test. Central macular thickness (CMT) was measured by fast macular scans using OCT. Retinal sensitivity (MS) and fixation patterns were evaluated by Mp-1. The position was chosen :2 disc diameters (DD) temporal to the disc and one third of a DD inferior to the centre of the disc. Results The correlation between CMT and BCVA is not significant (r＝－0.429，P=0.069) as well as the correlation between CMT and MS (r＝－0.433，P=0.058). The difference of CMT between the unstable and stable group was significant (F=3.262, P=0.039）. The difference of CMT between the central fixation group and preferred retinal locus (PRL) group was significant (F=3.173, P=0.044). Conclusions BCVA and MS have no significant correlation with CMT. When CMT increases, the fixation stability decreases, fixation location.changes, and PRL occurs.
Objective To observe the results of multifocal visual evoked potential (mfVEP) examination in patients with anterior ischemic optic neuropathy (AION) before and ater treatment, and to probe its clinical significance. Methods A total of 90 patients (90 eyes) with AION were examined by mfVEP; the secondorder reaction of mfVEP was analyzed.The reaction was divided into upper and lower hemi field of visual field, or 1/4 quadrant visual field (superior nasal, inferior nasal, superior temporal, and inferior temporal). The sum of waves of each response was analyzed and the results in various regions were compared.The features of wave configuration was compared between the AION eyes and the contralateral eye, and between the AION eyes before and after treatment.Results The amplitude and latency of P-wave of mfVEP was 0.198plusmn;0.033 and 100.197plusmn;7.354 respectively in AION eyes before treatment, and was 0.271plusmn;0.024 and 98.567plusmn;6.794 in the contralateral eyes; the difference was significant (t=16.556,18.330; Plt;0.01). The amplitude and latency of P-wave of mfVEP was 0.229plusmn;0.016 and 100.104plusmn;10.603 respectively in AION eyes after treatment, which differed much from that before the treatment (t=13.649, 8.858; Plt;0.01) and also from that of the contralateral eyes (t=13.649，8.858；P＜0.01). ConclusionsThe amplitude and latency of P-wave of mfVEP may accurately reflect the recovery of local optic nerve damage in AION eyes before and after treatment with good repeatability. AION can be used as a new method for AION diagnosis and detection of the prognosis.
Objective To observe the characteristics of fundus fluorescein angiography（FFA）and optical coherence tomography（OCT）in nonarteritic anterior ischemic optic neuropathy (NAION),and investigate its relation with visual acuity and course of disease.Methods The clinical data of 47 patients (47 eyes) with NAION were retrospectively analyzed. All the patiens had undergone visual acuity，fundus and visual field examination，meanwhile FFA and OCT were carried out at first visit. FFA and visual field were carried out by routine. OCT was carried out by line and circle shape scanning in macula and optic disc. Thirtyfive NAION patients were checked with OCT at half, one, two, three and six month after onset in respectively. Take the healthy fellow eyes of 36 NAION patiens as control group.The FFA,visual field,OCT characteristics and relation with visual acuity and course disease were comparatively analyzed.ResultsFFA showed that all the eyes appear as delayed filling of the optic disc in early stage and hyperfluorescence leakage of the optic disc in late stage，besides hyperfluorescence presented to macular area in 24 eyes. OCT showed that optic papilla swelling and physiological depression narrow or nearly disappearance, neuroepithelial layer thickening or neuroepithelial layer eminence and subretinal fluidity area opaca between optic disc and macula. There were 14 eyes with normal physiological depression and 22 eyes with small physiological depression or non physiological depression in control group. Half month after onset，the neuroepithelial layer thickness of macula fovea, the maximum thickness of neuroepithelial layer between optic disc and macula，and the average retinal nerve fiber layer（RNFL）thickness in NAION group were higher than those in the control group，the difference were statistically significant (F=6.51，26.12，75.49；P＜0.05).Two months after onset，the maximum thickness of neuroepithelial layer between optic disc and macula, the average RNFL thickness, and the RNFL thickness of temporal optic disc in NAION group were significant thinner, but the elevated height of the optic disc in NAION group were near those of the control group. Three months after onset，the average RNFL thickness and the RNFL thickness of temporal optic disc in NAION group decreased continually, they were lower than those of the control group, the difference were statistically significan（F=75.49，37.92；P＜0.05）.Visual field showed that inferior defect were found in 21 eyes (45%). With progress, the superior RNFL thickness obviously decreased, coincidence with appearance of visual field. It indicate that the superior optic atrophy serious. Visual acuity had significant negative correlation with the neuroepithelial layer thickness of macula fovea, the neuroepithelial layer maximum thickness between optic disc and macula, the average RNFL thickness, the RNFL thickness of temporal optic disc(r=-0.394,-0.424,-0.412,-0.464；P＜0.05).Conclusions FFA showes that hyperfluorescence leakage appearanced in part macula. OCT showes that RNFL becomes thinner as the disease duration increases. The results of OCT and visual field examinaion in the configuration of optic disc and changes of RNFL are accordant.
Objective To evaluate the applic ation of blue-on-yellow(B/Y) perimetry in detecting the early visual field loss of glaucoma． Methods The B/Y perimetry of the G2 strategy in the OCTOPUS 101 perimetry was used to examine the visual field of 16 normal persons (32 eyes), 25 cases (35 eyes) of primary open-angle glau coma (POAG) with abnormal white-on-white (W/W) visual fields, 15 cases (15 eye s) of early POAG with normal W/W visual field, and 11 cases (22 eyes) of suspect ed POAG． Results The mean sensitivity (MS) in the normal cases, suspected POAG, early POAG, middle POAG, and late POAG was ( 23．24plusmn;1．22) dB，(20．97plusmn;3．42) dB，(18．44plusmn;3．57) dB，(11．04plusmn;1．85) dB and (8．55plusmn;2．29) dB, respectively． It was demonstrated that B/Y perimetry was more sensitive than W/W perimetry in detecting the glaucomatous visual fi eld defects,and its sensitivity was 92% and specificity was 90．62%． The averag e number of defective points in central visual field with B/Y perimetry was more than that with W/W perimetry in early and middle POAG． Conclusion B/Y perimetry is a relatively sensitive method for detection of the early visual field loss in POAG． (Chin J Ocul Fundus Dis, 2001,17:125-127)
Objective To observe the fixation features of foveoschisis in pathological myopia patients. Methods 36 patients (42 eyes) with gt;6.00 D myopic degree and foveoschisis who diagnosed by optical coherence tomography were included. The patients were divided into foveoschisis with retinal detachment group (11 eyes), foveoschisis with macular hole group (12 eyes) and only foveoschisis group (19 eyes). Micro-perimeter MP-1 was used to identify the fixation location and fixation stability. Results The eccentric fixation were formed above the fovea in the foveoschisis with retinal detachment and foveoschisis with macular hole group, the fixation location was formed on fovea in the only foveoschisis group. The fixation stability of the foveoschisis with retinal detachment, foveoschisis with macular hole and only foveoschisis group were (23plusmn;4)%,(59plusmn;6)%,(91plusmn;11)% respectively, the difference was statistically significant (F=243.47，P＜0.01). Conclusions The fixation location is formed on fovea in the patients with foveoschisis in pathological myopia. The eccentric fixation is formed above the fovea in the patients who has foveoschisis with retinal detachment and macular hole in pathological myopia.
Objective To investigate the distribution of the preferred retinal locus (PRL) of eccentric fixation in eyes with high myopia.Methods A total of 40 highly myopic patients (54 eyes ) with eccentric fixation were examined by MP1 microperimeter to identify the PRL. The position of PRL relative to the fovea was estimated using the 90% confidence ellipse of normal adult foveal fixation. The differences of visual acuity between ldquo;desirablerdquo; and ldquo;undesirablerdquo; PRL were tested by analysis of variance.Results In 54 eyes with high myopia, 24 eyes (44.44%) had PRL of eccentric fixation below the scotoma after loss of central vision; 19 eyes ( 35.19% ) had a leftfield PRL; 6 eyes ( 11.11% ) had an upperfield PRL; and 5 eyes ( 9.26% ) had rightfield PRL. In 14 patients who had binocular eccentric fixation, 13 had the same fixation pattern in both eyes, including lowerfield PRL in 7 （50.00%）, leftfield PRL in 5 （35.71%）, and upperfield PRL in 1 patient （7.14%）. The difference of visual acuity between lower and leftfield PRL group and right and upperfield undesirable PRL group was not statistically significant（F=0.144, Pgt;0.05）. Conclusions The eccentric fixation in eyes with high myopia is usually situated as near as possible to the fovea. The optimal PRL is inferior visual field.
Objective To observe the relationship between position of normal central fixation and the position of the optic disc, and to find out the features of stability of fixation. Methods The position of central fixation of 120 eyes of 60 healthy adults was determined by MP-1 microperimeter. The position of central fixation relative to the position of the optic disk was measured. The relationship between the central fixation and the age or refraction was analyzed statistically. The difference between the right and left eye in each individual was analyzed with t test. Results The central fixation located at the retina with the horizontal distance of 14.48deg;plusmn;1.85deg; and vertical distance of －2.14deg;plusmn;1.26deg; from the temporal edge of the optic disk. In the 120 eyes, 90% of the central fixation located in a bivariate normal ellipse. The normal eyes usually kept in a slightly moving condition when a normal person fixing on a subject. The median of horizontal and vertical deviation was 0.4deg; and 0.3deg; respectively. Conclusion The distribution of central fixation in healthy adults is a bivariate normal ellipse. When fixing on a subject, the moving extent of the eyes in the horizontal direction is larger than that in the vertical direction.