Detection of Visual Field Loss in Pituitary Disease: Peripheral Kinetic Versus Central Static. (June 2015)

• Record Type: Journal Article
• Authors: Rowe, Fiona J.; Cheyne, Christopher P.; García-Fiñana, Marta; Noonan, Carmel P.; Howard, Claire; Smith, Jayne; Adeoye, Joanne
• Is Part Of: Neuro-ophthalmology. Volume 39:Number 3(2015:Jun.)
• Page Start: 116
• Page End: 124
• Publication Date: 2015-06
• Subjects: Neuroophthalmology -- Periodicals; 617.7
• DOI: 10.3109/01658107.2014.990985
• Languages: English
• ISSNs: 0165-8107

Abstract

<abstract> <title>Abstract</title> <p>Visual field assessment is an important clinical evaluation for eye disease and neurological injury. We evaluated Octopus semi-automated kinetic peripheral perimetry (SKP) and Humphrey static automated central perimetry for detection of neurological visual field loss in patients with pituitary disease. We carried out a prospective cross-sectional diagnostic accuracy study comparing Humphrey central 30-2 SITA threshold programme with a screening protocol for SKP on Octopus perimetry. Humphrey 24-2 data were extracted from 30-2 results. Results were independently graded for presence/absence of field defect plus severity of defect. Fifty patients (100 eyes) were recruited (25 males and 25 females), with mean age of 52.4 years (SD = 15.7). Order of perimeter assessment (Humphrey/Octopus first) and order of eye tested (right/left first) were randomised. The 30-2 programme detected visual field loss in 85%, the 24-2 programme in 80%, and the Octopus combined kinetic/static strategy in 100% of eyes. Peripheral visual field loss was missed by central threshold assessment. Qualitative comparison of type of visual field defect demonstrated a match between Humphrey and Octopus results in 58%, with a match for severity of defect in 50%. Tests duration was 9.34 minutes (SD = 2.02) for Humphrey 30-2 versus 10.79 minutes (SD = 4.06) for Octopus perimetry. Octopus semi-automated kinetic perimetry was found to be superior to central static testing for detection of pituitary disease-related visual field loss. Where reliant on Humphrey central static perimetry, the 30-2 programme is recommended over the 24-2 programme. Where kinetic perimetry is available, this is preferable to central static programmes for increased detection of peripheral visual field loss.</p> </abstract>