Praktische Aspekte der Perimetrie beim Glaukom

Abstract

Automatic static white-on-white perimetry is state of the art for the visual field examination of glaucoma patients. Full threshold measurements require at least 5 min. Careful instruction and supervision of the patient help to achieve high quality results. Alternative methods, such as the various types of flicker perimetry have a higher sensitivity and complement the early diagnosis. Attention must be paid to the specificity of these methods. Diagnosis may be difficult because the first changes do not have a typical topography. The typical examination interval for follow-up is 1 year but should be shorter in the beginning and in cases with deterioration. The evaluation of visual field development is highly important for glaucoma therapy control. Modern analysis programs offer excellent tools for this purpose. Some programs automatically detect learning effects and unreliable examinations. The change in global indices, e.g. median defect depth (MD), functional defect (FD) and visual field index (VFI) is plotted and statistically analyzed. Local trends are shown in symbol maps. Some programs calculate a prognosis of the future development of the visual field.