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Landmark-driven fundus perimetry using the scanning laser ophthalmoscope
J S Sunness1, R A Schuchard, N Shen
1Lions Vision Center, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Investigative Ophthalmology & Visual Science
|August 1, 1995
Summary
This new scanning laser ophthalmoscope perimetry method accurately tests retinal sensitivity by compensating for eye movements using retinal landmarks. It enables reliable longitudinal testing, even for patients with central vision loss.
Area of Science:
- Ophthalmology
- Visual Neuroscience
- Medical Imaging
Background:
- Scanning laser ophthalmoscope perimetry is crucial for assessing visual field defects.
- Accurate retinal localization is essential for reliable perimetry, but eye movements pose a significant challenge.
- Existing methods struggle with fixation changes, limiting longitudinal studies and testing in patients with central scotomas.
Purpose of the Study:
- To introduce a novel scanning laser ophthalmoscope perimetry technique that corrects for eye movements.
- To enable accurate testing of retinal sensitivity at specific locations despite fixation instability.
- To facilitate repeatable longitudinal assessments and testing in patients with central visual field loss.
Main Methods:
- A landmark-driven approach identifies a retinal feature (e.g., vessel bifurcation) for fixation.
- The computer system adjusts stimulus presentation based on landmark position, compensating for eye drift.
- Results are mapped to the correct retinal location on a fundus image post-testing.
Main Results:
- The landmark-driven method demonstrated high accuracy and repeatability in 67 eyes with macular disease.
- A low rate of inconsistent test points was observed, correlating with scotoma severity and reduced visual acuity.
- The technique effectively corrected retinal localization errors caused by significant eye movements, proving rapid and easy to administer.
Conclusions:
- This landmark-guided perimetry provides accurate and repeatable retinal sensitivity measurements.
- The method is valuable for monitoring disease progression over time.
- Further development could lead to fully automated, retinally accurate perimetry testing.