Study of Optimal Perimetric Testing in Children (OPTIC): evaluation of kinetic approaches in childhood neuro-ophthalmic disease. Issue 8 (19th September 2018)

• Record Type: Journal Article
• Authors: Patel, Dipesh E; Cumberland, Phillippa M; Walters, Bronwen C; Cortina-Borja, Mario; Rahi, Jugnoo S
• Other Names: Khaw Peng Tee author non-byline.; Walters Bronwen author non-byline.; Cumberland Phillippa M author non-byline.; Russell-Eggitt Isabelle author non-byline.; Timms Chris author non-byline.; Brookes John author non-byline.; Moore Anthony author non-byline.; Papadopoulos Maria author non-byline.; Garway-Heath David author non-byline.; Viswanathan Ananth author non-byline.; Liasis Alki author non-byline.; Crabb David author non-byline.; Cortina-Borja Mario author non-byline.; Patel Dipesh E author non-byline.; Rahi Jugnoo S author non-byline.
• Is Part Of: British journal of ophthalmology. Volume 103:Issue 8(2019)
• Page Start: 1085
• Page End: 1091
• Publication Date: 2018-09-19
• Subjects: field of vision -- child health (paediatrics) -- diagnostic tests/investigation -- visual pathway; Ophthalmology -- Periodicals; 617.7
• DOI: 10.1136/bjophthalmol-2018-312591
• Languages: English
• ISSNs: 0007-1161

Abstract

Abstract : Aims: We compared feasibility, quality and outcomes of visual field (VF) testing in children with neuro-ophthalmic disease between the discontinued 'gold-standard' Goldmann and Octopus perimeters. Methods: Children with neuro-ophthalmic disease, attending Great Ormond Street Hospital, London, were assessed using standardised protocols by one examiner in a single sitting, using Goldmann and Octopus kinetic perimetry. Outputs were classified to compare severity of loss and defect type. Test quality was assessed using both qualitative and quantitative methods. Results: Thirty children (40% female) aged 5–15 years participated. Goldmann perimetry was completed in full by 90.0% vs 72.4% for Octopus. Inability to plot the blind spot was the most common reason for not completing testing. Over 75% completed a test in ≤20 min. Duration was similar between perimeters (paired t-test, mean difference: 0.48min (−1.2, 2.2), p=0.559). The lowest quality tests were for Octopus perimetry in children <8 years, without significant differences between perimeters in older children (McNemar's test, χ 2 =1.0, p=0.317). There was broad agreement between Goldmann and Octopus outputs (good quality, n=21, Bland-Altman, mean difference for isopters I4e (−514.3 deg 2 (−817.4, –211.2), p=0.814), I2e (−575.5 deg 2 (−900.1, –250.9), p=0.450) and blind spot (20.8 deg 2 (5.7, 35.8), p=0.451)). However, VF severity grades and defect type matched in only 57% and 69% of tests, respectively. Octopus perimetry underestimated severe VF defects. Conclusions: Informative perimetry is feasible in children ≥8 years with neuro-ophthalmic conditions, with either Goldmann or Octopus perimeters. However, meaningful differences exist between the two approaches with implications for consistency in longitudinal assessments.