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Humphrey Field AnalyzerTM

The document discusses various types of perimetry tests used to evaluate the visual field, including manual and automated perimetry tests. It provides details on Humphrey automated perimetry including how the test is performed, what it measures, how to analyze results, and common artifacts. It also describes different stages of visual field loss from early to severe defects and how they appear on Humphrey perimetry tests.

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sayumiholic89
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283 views

Humphrey Field AnalyzerTM

The document discusses various types of perimetry tests used to evaluate the visual field, including manual and automated perimetry tests. It provides details on Humphrey automated perimetry including how the test is performed, what it measures, how to analyze results, and common artifacts. It also describes different stages of visual field loss from early to severe defects and how they appear on Humphrey perimetry tests.

Uploaded by

sayumiholic89
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Tes konfrontasi

Tes Amsler grid


Manual perimetry (stimulus dipindahkan
secara manual, contoh: Perimetri Goldmann)
Automated perimetry (stimulus berpindah
secara otomatis dengan program komputer,
contoh: Humphrey Field AnalyzerTM , Optopol
Perimatry).
Adalah perimeter dengan sistem
komputerisasi: menentukan sensitivitas
ambang lapang pandangan pada beberapa
titik.
Intensitas stimulus bervariasi.
Octopus & Humphrey Field Analizer (HFA).
Optopol Perimetry Humphrey VF
Pasien dijelaskan prosedur tindakan.
Tutup mata pasien yang tidak diperiksa.
Pasien duduk di depan kubah perimetri dan
meletakkan dagu pada tempatnya.
Ketika tes dimulai, secara otomatis komputer
akan memindahkan stimulus dengan
intensitas sinar yang berbeda.
Lakukan pemeriksaan pada mata satunya
apabila diperlukan.
Print hasil tes.
1. Kualitas :
False-negatif dan false-positif (baik apabila
<20%).
2. Nilai normal / abnormal :
- sensitivitas di sentral lebih besar dari
pada perifer normal.
- nilai defek lapang pandangan yang
terjadi.
Projection type automated static
perimeter.
Most popular, consistency of basic
hardware,
constant upgradation of the
software on the basis of clinical
feedback from the
ophthalmologists.
The machine:
Viewing distance-33cms.
Background illumination-31.5asb.
Static mode, newer models - kinetic.
Stimulus size:
Goldman stimulus
size(1to5)
Stimulus
duration:0.2
second.
Fixation monitor:
Heijl Krakau blind
spot technique,
gaze monitoring.
Data storage.
STATPAC: computerised statistical package
Comparison of patients results with age matched
normal data.
Patients own baseline with follow up data.
Newer HFA series: database of stable glaucoma
patients for glaucoma change probability analysis.
Recognise artifacts:

Reliability.

Assessment of damage.
Baseline visual field exam:
2 fields min. baseline.
1st field-Central 30-2 threshold
2nd -central 30-2 threshold within 1 to 2
months.

Provided:
Consistent
,no learning effect.
<2dB (MD).

If1st field constricted or depressed:


Obtain 10-2 threshold test.
Retest with size5 stimulus(64mm2).
Or combine.
Lid.
Lens rim-too far or the eye is not
centered.
Refractive error.
Learning effect.
Pupillary size.
Rapid fatigue.
False positives-tendency of the patient
to press the trigger not in response to
seeing a stimulus but at random, either
as a response to an audible cue or due
to the expectation of the stimulus.
Ratio of such responses to the number
of FP catch trials done.
>33%FP rate is flagged with a double
XX.
Low reliability.
False negative responses are failure of the
patient to respond to stimulus 9 dB more
intense than the previously determined
threshold at that point due to patient
inattention or fatigue.
Reason may be a tired patient.
A high FN rate may or may not be reliable.
Cloverleaf defect due to high FN.
Not all fixation losses represent true loss of
fixation.
High fixation loss may indicate, centre of
blind spot was slightly mislocated.
If FP, FN rates and STF are low, then the high
FL can be discounted.
If two baseline fields are similar it can again
be discounted.
Mislocation of the blind spot.
Macular disease.
Testing option, shows variability of patients
response over a single test period.

low (2dB) SF- good reproducibilty


high ( 3dB) SF-poor reproducibility
A Glaucoma Hemifield Test outside normal
limits on at least two fields.
or

A cluster of three or more non edge points in a


location typical for glaucoma, all of which are
depressed on the PD plot at p<5% level and
one of which is depressed at p <1%level on
two consecutive fields.
Early defect:
Neither extensive nor near fixation.
Mean deviation index (MD) better than -6dB.
On PD plot:
1.<25%(18) points are below 5% level.
2.< 10 points below 1% level.
Central 5-no points having less than 15dB sensitivity.
Moderate defect:
MD<-12dB.
1.PD-<50%( 37) points < 5% and < 20 points <1%.
Central 5-no points with 0dB.
Only one hemifield may have a point in central 5
with <15dB sensitivity.
Severe defect:
Any of the following:
1.MD plot >-12dB
2.PDplot:
>37 points depressed below<5%.
>20 points depressed below 1%.
Any point in central 5has sensitivity of 0dB.
Central 5-points <15dB in both hemispheres.
1.new defect.
2.deepening of pre exisiting defect.
3.expansion of pre existing defect.
4.entire field develops decreased sensitivity.
Skotoma Parasentral
Hilangnya penglihatan absolut / relatif
pada area 10 0 dari fiksasi
Hilangnya serabut saraf pole inferior yaitu
retina inferotemporal (Skotoma
superonasal)
Skotoma parasentral bisa single atau
multiple
Skotoma Arkuata
Terjadi dalam area 10 200
dari fiksasi.
Kerusakan akson serabut saraf
dari retina inferonasal &
inferotemporal
Mulai pada satu area,
kemudian meluas ke bagian
nasal.
Bentuk komplit : skotoma
dari bintik buta yang meluas
ke nasal.
Nasal Step
Kerusakan serabut
saraf superior
retina superotemporal
yang melebihi area
parasentral
Temporal Step
Suatu defek lapang
pandangan berlapis-lapis
yang meluas dari bintik
buta ke temporal atau dari
perifer ke bintik buta
Kerusakan serabut saraf
inferonasal retina
superotemporal sampai
bintik buta
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