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A screening method for chiasmal visual-field defects

J D Trobe, P C Acosta, J P Krischer

    Archives of Ophthalmology (Chicago, Ill. : 1960)
    |February 1, 1981
    PubMed
    Summary
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    A new visual field testing strategy is as effective as traditional methods for detecting chiasmal hemianopic defects but is four times faster. This efficient approach could improve visual field testing for unexplained vision loss.

    Area of Science:

    • Ophthalmology
    • Neuro-ophthalmology
    • Visual Psychophysics

    Background:

    • Visual field testing is crucial for diagnosing visual field defects.
    • Conventional methods like Goldmann perimetry can be time-consuming.
    • Chiasmal hemianopic defects require accurate and efficient detection.

    Purpose of the Study:

    • To evaluate a novel, time-efficient strategy for visual field testing.
    • To compare the sensitivity and specificity of this strategy against conventional methods.
    • To assess its utility in detecting chiasmal hemianopic field defects.

    Main Methods:

    • A selective vertical fixational meridian exploration strategy was employed.
    • Testing was performed by a masked perimetrist on 28 eyes with hemianopic defects, 17 with nerve-fiber defects, and 14 normal eyes.

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  • Results were compared with Goldmann perimetry, conventional tangent screen, and projection tangent screen perimetry.

    • Main Results:

    • The novel strategy detected 100% of hemianopias, comparable to Goldmann perimetry.
    • Detection rates were 92% for the conventional tangent screen and 87% for the projection tangent screen.
    • False-positive rates for hemianopic defects ranged from 11% to 16% across methods.

    Conclusions:

    • The abbreviated visual field testing strategy is highly sensitive for detecting important diagnostic features of hemianopic defects.
    • Its efficiency significantly reduces testing time compared to conventional perimetry.
    • This approach may promote wider use of visual field testing in managing patients with unexplained visual loss.