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      Normal Values for the Full Visual Field, Corrected for Age- and Reaction Time, Using Semiautomated Kinetic Testing on the Octopus 900 Perimeter

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          Abstract

          Purpose

          To determine normal values of the visual field (VF), corrected for age and reaction time (RT) for semiautomated kinetic perimetry (SKP) on the Octopus 900 perimeter, create a model describing the age-dependency of these values, and assess test–retest reliability for each isopter.

          Methods

          Eighty-six eyes of 86 ophthalmologically healthy subjects (age 11–79 years, 34 males, 52 females) underwent full-field kinetic perimetry with the Octopus 900 instrument. Stimulus size, luminance, velocity, meridional angle, subject age, and their interactions, were used to create a smooth multiple regression mathematical model (V/4e, III/4e, I/4e, I/3e, I/2e, I/1e, and I/1a isopters). Fourteen subjects (2 from each of 7 age groups) were evaluated on three separate sessions to assess test–retest reliability of the isopters. Reaction time (RT) was tested by presenting 12 designated RT-vectors between 10° and 20° within the seeing areas for the III/4e isopter (stimulus velocity, 3°/second). Four RT- vectors were presented at the nasal (0° or 180°), superotemporal (45°), and inferior (270°) meridians.

          Results

          The model fit was excellent ( r 2 = 0.94). The test–retest variability was less than 5°, and the median decrease in this deviation attributed to aging, per decade, for all age groups and for all stimulus sizes was 0.8°. No significant learning effect was observed for any age group or isopter.

          Conclusion

          Age-corrected and RT-corrected normative threshold values for full-field kinetic perimetry can be adequately described by a smooth multiple linear regression mathematical model.

          Translational Relevance

          A description of the entire kinetic VF is useful for assessing a full characterization of VF sensitivity, determining function losses associated with ocular and neurologic diseases, and for providing a more comprehensive analysis of structure–function relationships.

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          Most cited references33

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          Aging of the human retina. Differential loss of neurons and retinal pigment epithelial cells.

          The impact of aging on cell loss in the human retina was examined in foveal and temporal equatorial regions in eyes from 35 donors with ages spanning a 78-yr period from the second to the ninth decade of life. Equatorial cones and retinal pigment epithelial cells (RPE) decreased at uniform rates from the second to the ninth decade, 16 and 14 cells/mm2/yr, respectively. Equatorial rods and cells in the ganglion cell layer (GCL) showed nonuniform rate decreases with age. The rates of rod and GCL cell loss were faster between the second and fourth decades (970 and 9 cells/mm2/yr, respectively) than between the fourth and ninth decades (570-330 and 6-3 cells/mm2/yr). The rod and GCL cell densities at the temporal equator maintained a constant ratio (rods-GCL cell ratio = 103 +/- 0.4, mean +/- standard deviation) and the same reduction slope ratio at different times during aging. Thus, the equatorial rod and GCL cell losses were correlated statistically. The ratio of equatorial photoreceptors to RPE cells showed no significant change with age, suggesting parallel loss of these closely apposed cells. At the foveal center, the variability of cone density between individuals in each decade grouping was large (1.7- to threefold). No significant differences were found in cone or RPE cell densities at the foveal center from the second to ninth decade, suggesting that the densities of foveal cones and RPE cells were stable throughout this period. Foveal RPE density was significantly higher than equatorial RPE density in each age group. No significant difference was found between the equatorial photoreceptor-RPE ratio and foveal cone-RPE ratio in any age group. Cells in the GCL in the fovea decreased by approximately 16% from the second to the sixth decade. These results indicated that (1) rod photoreceptors and cells in the GCL were more vulnerable to loss during aging than cones; (2) photoreceptors and RPE cells showed parallel changes during aging; and (3) the photoreceptor loss accompanying aging was less pronounced in the fovea than in the peripheral retina.
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            The effect of age on the nerve fiber population of the human optic nerve.

            Nerve fiber counts of 16 normal human optic nerves from subjects aged 3.5 to 82 years showed a significant effect of age (P = .0207). The delay between death or enucleation and fixation also significantly affected the result (P = .0078). The mean (+/- S.E.M.) count for the 16 nerves was 1,244,005 +/- 20,033 fibers, giving a 99% confidence level between 1,192,400 and 1,295,610 fibers.
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              • Article: not found

              The effect of perimetric experience in normal subjects.

              Two groups of normal subjects were submitted to repeated automated static threshold perimetry. Perimetric results were strongly affected by the level of experience in some subjects; in the majority, however, the effect of experience was small. Initial field tests often showed high numbers of depressed points. Sensitivity increased with perimetric training, particularly between the first sessions. Those subjects who improved most started low, gradually approaching normal levels with experience. Learning effects were more pronounced peripherally than paracentrally and "untrained" fields characteristically showed concentric contraction with numerous points with low sensitivity peripherally. An important practical conclusion is to allow repeated testing of all inexperienced patients in whom initial fields do not agree with clinical findings. A chart showing a concentrically narrowed field should be viewed with particular suspicion. Furthermore, a single initial field may constitute an inadequate baseline for clinical follow-up.
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                Author and article information

                Journal
                Transl Vis Sci Technol
                Transl Vis Sci Technol
                tvst
                tvst
                tvst
                Translational Vision Science & Technology
                The Association for Research in Vision and Ophthalmology
                2164-2591
                4 March 2016
                March 2016
                : 5
                : 2
                : 5
                Affiliations
                [1 ]Centre for Ophthalmology/Institute for Ophthalmic Research, University of Tübingen, Germany
                [2 ]Institute for Medical Biometry and Statistics and the Center for Clinical Trials, University of Lübeck, Germany
                [3 ]Casey Eye Institute, Oregon Health & Science University, Portland, OR, USA
                [4 ]Department of Ophthalmology and Visual Sciences and Wynn Institute for Vision Research, University of Iowa, Iowa City, IA, USA
                [5 ]Competence Center Vision Research, Study Course “Ophthalmic Optics and Audiology”, Faculty of Optics and Mechatronics, University of Applied Sciences, Aalen, Germany
                Author notes
                Correspondence: Chris A. Johnson, PhD, Department of Ophthalmology and Visual Sciences and Wynn Institute for Vision Research, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, USA 52242-1091; e-mail: chris-a-johnson@ 123456uiowa.edu
                Article
                tvst-05-02-06 MS#: TVST-15-0201
                10.1167/tvst.5.2.5
                4782826
                26966641
                8a633bc5-c028-45aa-bed3-415d84784a23

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 12 January 2015
                : 16 March 2015
                Categories
                Articles

                perimetry,visual fields,semiautomated kinetic testing,full visual field,normal values

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