Rarebit Perimetry and Optic Disk Topography in Pediatric Glaucoma

Abstract

To determine the relationship between visual field and optic nerve topography findings in a cohort of children with pediatric glaucoma and an age-matched and sex-matched control Fifteen children, aged 6 to 15 years, with pediatric glaucoma in at least one eye and 15 age-matched and sex-matched healthy children were examined with best-corrected visual acuity and perimetry. When possible, scanning laser topography of the optic disk (ie, Heidelberg retinal tomography) was performed. Of 27 eyes in 15 children with pediatric glaucoma examined with Goldmann perimetry, 15 eyes (55%) had a normal visual field. Of 24 eyes examined with Rarebit perimetry, 8 eyes (33%) showed normal results and 16 eyes (67%) showed an abnormally low hit rate (ie, the fraction of seen targets vs presented targets). Nine of the 15 eyes showing normal Goldmann visual fields had a subnormal Rarebit hit rate. All children in the control group had normal Rarebit visual fields. Heidelberg retinal tomography could be performed in all healthy children and in 22 eyes of 13 children with pediatric glaucoma. The concordance between the Heidelberg retinal tomography classification (ie, normal or glaucoma) and the Rarebit results was high (Cohen's kappa = 0.79). A statistically significant correlation (r = 0.66, P = .006) between Rarebit hit rate and Heidelberg retinal tomography glaucoma index was found in the glaucoma group. Rarebit perimetry detected glaucomatous damage in various types of pediatric glaucoma, and can be assumed to be of value in both diagnosis and follow-up. In 13 children with glaucoma, Heidelberg retinal tomography could be performed. The results conformed well to Rarebit findings.