Original ArticlesA comparison of tangent screen, Goldmann, and Humphrey perimetry in the detection and localization of occipital lesions1☆,
Section snippets
Materials and methods
Consecutive patients with homonymous hemianopia on screening with Humphrey perimetry were recruited into the study from the Neuro-ophthalmology Unit at The Toronto Hospital. Serial axial and sagittal T1-weighted (TR, 516–517 msec; TE, 8–11 msec) and T2-weighted (TR, 2200–4383 msec; TE, 80–95 msec, two separate acquisitions) MR images were obtained (slice thickness, 5 mm), with the Signa 1.5 Tesla system (version 5.4.2/General Electric Medical Systems, Milwaukee, WI). Patients with well-defined
Results
Twelve patients had reliable fields in all three perimetric examinations and well-defined occipital infarcts on MRI and were included in the analysis. There were nine men and three women, with a mean age of 57.5 years (range, 29–80 years). The mean duration of patients’ symptoms of impaired vision was 8 months (range, 4–20 months). The results of visual field examinations using tangent screen, Goldmann, and Humphrey perimetry are shown in Figure 1.
Table 1 summarizes our interpretation of the
Discussion
With the advent of newer generations of automated perimeters and the availability of more sophisticated software programs, such as STATPAC of the Humphrey Field Analyzer, automated perimetry is increasingly relied on for detection and localization of visual pathway damage in clinical practice. Establishing its ability to detect abnormal fields and its accuracy to localize lesions is important for the diagnosis and management of neurologic diseases. Prior studies have shown that automated
Conclusion
The results of this investigation indicate that both manual kinetic perimetry (tangent screen and the Goldmann perimeter) and automated static perimetry (Humphrey Field Analyzer) are satisfactory as screening tests to detect occipital lesions. However, tangent screen and Goldmann perimetry provide information about the location and extent of lesions as identified by MRI that is most consistent with prevailing knowledge12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22of the perimetric effects of
References (37)
- et al.
Automated perimetry detects visual field loss before manual Goldmann perimetry
Ophthalmology
(1995) - et al.
A clinical comparison of visual field testing with a new automated perimeter, the Humphrey Field Analyzer, and the Goldmann perimeter
Ophthalmology
(1985) - et al.
Suprathreshold static perimetry in glaucoma and other optic nerve disease
Ophthalmology
(1979) - et al.
Computerized perimetry in neuro-ophthalmology
Ophthalmology
(1979) - et al.
Congruous and incongruous sectoral visual field defects with lesions of the lateral geniculate nucleus
Am J Ophthalmol
(1984) Plasticity in visual perception and physiology
Curr Opin Neurobiol
(1996)- et al.
High-pass resolution perimetry in neuro-ophthalmology. Clinical impressions
Ophthalmology
(1992) - et al.
A comparison of Goldmann and Humphrey automated perimetry in patients with glaucoma
Br J Ophthalmol
(1987) Automated (Octopus) and manual (Goldmann) perimetry in glaucoma
Albrecht von Graefes Arch Exp Ophthalmol
(1980)- et al.
Automated and manual perimetry—a six-year overview. Special emphasis on neuro-ophthalmic problems
Ophthalmology
(1983)
The Visual FieldsText and Atlas of Clinical Perimetry
Wounds of the visual pathway.Part II: The striate cortex
J Neurol Neurosurg Psychiatry
Visual field changes after temporal lobectomy in man
Neurology
The architecture of the optic radiation in the temporal lobe of man
Brain
Visual field changes following anterior temporal lobectomytheir significance in relation to “Meyer’s loop” of the optic radiation
Brain
Cited by (38)
Retrochiasmal Disorders
2018, Liu, Volpe, and Galetta's Neuro-Ophthalmology: Diagnosis and ManagementEvaluation of stimulus velocity in automated kinetic perimetry in young healthy participants
2014, Vision ResearchCitation Excerpt :Kinetic perimetry is the traditional method used to measure the extent of the visual field via an examiner controlling a moving stimulus (Goldmann, 1945a, 1945b, 1946). This technique is useful when examining patients without visual field defects within the central 30° (Hicks & Anderson, 1983; Keltner et al., 1999; Stewart, 1992) or patients with intracranial disease (Keltner & Johnson, 1984; Wong & Sharpe, 2000). Manual kinetic perimetry has the advantage of obtaining measurements while keeping pace with the patient’s response time for stimulus exposure.
Spatial and temporal stimulus variants for multifocal pupillography of the central visual field
2011, Vision ResearchCitation Excerpt :The current clinical standard for assessing function across the visual field is static automated perimetry (SAP), which is based on stimuli from the 1945 Goldmann perimeter (Wong & Sharpe, 2000).
Disorders of the optic tract, radiation, and occipital lobe
2011, Handbook of Clinical NeurologyCitation Excerpt :Some 83% of occipital lobe lesions produce a congruous HH (Kedar et al., 2007). Although visual field defects relating to occipital disease are detected equally well by automated static perimetry, Goldmann perimetry, and tangent screen, certain localizing features (described below) of these visual field defects may elude detection using automated perimetry, and manual Goldmann perimetry may be preferable (Wong and Sharpe, 2000). The most anterior 8–10% of visual cortex receives monocular innervation from the contralateral retina, and represents the most peripheral 30° of temporal visual field in that eye.
Homonymous central quadrantanopia caused by an extrastriate (V2/V3) infarction: A case report
2008, Kaohsiung Journal of Medical SciencesComparison of unifocal, flicker, and multifocal pupil perimetry methods in healthy adults
2022, Journal of Vision
- ☆
Supported by Medical Research Council of Canada Grant MA15362 and by the E. A. Baker Foundation, Canadian National Institute for the Blind.
- 1
The authors have no commercial interests in any products described in the manuscript.