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Chapter-06 Automated Visual Field Assessment, Optic Nerve and Nerve Fiber Layer Imaging

BOOK TITLE: Clinical Ophthalmology: Medical and Surgical Approach

Author
1. Vijaya Lingam
2. Baskaran M
3. Narayanaswamy Arun
ISBN
9789350250044
DOI
10.5005/jp/books/11246_6
Edition
2/e
Publishing Year
2011
Pages
19
Author Affiliations
1. Sankara Nethralaya, Chennai, India, Sankara Nethralaya Chennai, Tamil Nadu, India, Sankara Nethralaya, Chennai, Tamil Nadu, India
2. Sankara Nethralaya, Chennai, India, Sankara Nethralaya Chennai, Tamil Nadu, India, Shankara Nethralaya, Chennai
3. Sankara Nethralaya Chennai, Tamil Nadu, India, Sankara Nethralaya, Chennai, India
Chapter keywords

Abstract

This chapter would aim at broadly familiarizing oneself with the parameters of an automated visual field and a systematic evaluation to help differentiate between a normal and an abnormal field. A visual field is one of the principal components in the diagnosis of glaucoma. Documenting it has had a rapid evolution from manual to semiautomatic and now completely automated quantitative plotting of a field. The sound concepts introduced by Goldmann still forms the basis of automated perimetry though technology has made things faster, more detailed and statistically comparable. Software in these new generation machines has detailed data regarding the threshold sensitivity for each point for normal as well as glaucomatous patients. This data is compared with the patient data giving us a statistical probability and helps identify an abnormal field with a certain degree of accuracy. Description would be limited to Humphrey field analyzer (HFA-II, Humphrey Systems, Dublin, CA, USA) results since it is the most widely used automated perimeter and programs of which we are most familiar with. It is very essential that a field report be always interpreted along with clinical data and never in isolation. Over the past decade computerized imaging technologies have evolved and been extensively refined for clinical assessment of the optic nerve and retinal nerve fiber layer. It is very important to remember that all these technologies can only serve as adjuncts and data generated by these are best used with comprehensive information derived from clinical evaluation of the patient. The following technologies are currently the mainstay of optic nerve and nerve fiber layer imaging: (i) Confocal scanning laser ophthalmoscopy (Heidelberg Retinal Tomograph [HRT]; Heidelberg Engineering, Heidelberg, Germany), (ii) Scanning laser polarimetry (GDx VCC; Carl Zeiss Meditec, Dublin, CA, USA), and (iii) Optical coherence tomography (OCT; Carl Zeiss Meditec, Dublin, CA, USA).

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