Escala NEI VFQ-25 como instrumento de medición de la calidad de vida relativa a la visión / NEI VFG-25 scale as a measuring instrument of the vision-related quality of life

La salud es un elemento decisivo de la calidad de vida. El concepto de calidad de vida es cada vez más utilizado como medida del bienestar y depende de elementos objetivos y de la valoración subjetiva que el paciente hace de diferentes aspectos de su vida. Las pruebas de calidad de vida son adaptables al campo de la Oftalmología y aplicables a cualquier paciente, además de las pruebas de función visual. El NEI VFQ-25 mide las dimensiones del estado de salud orientado a la visión. El uso de estos estudios permite conocer la respuesta clínica y el grado de satisfacción del paciente, lo que conlleva una mejor calidad de vida. Con la presente investigación se pretende mostrar una de las pruebas más utilizadas para describir los resultados de la calidad visual(AU)

The health is a decisive element of the life quality. The quality of life concept is more and more utilized, it depends on objective elements, and subjective opinion of the patient makes of different aspects of its life. The quality of life test is adaptive to the ophthalmology patient, beside the tests of visual function. The NEI VFQ-25, measures the dimensions from the health to the vision. The use of these studies allows knowing the clinical response and the patient satisfaction, what means a better life quality(AU)

[Visual field defects after epilepsy surgery: implications for driving license tenure]. / Gesichtsfelddefekte nach epilepsiechirurgischen Eingriffen : Bedeutung für die Fahrerlaubnis.

BACKGROUND: Epilepsy surgery is an effective and established therapy in medically uncontrollable seizure disorders. In the course of such operations lesions of the visual pathway are often unavoidable. The resultant visual field defects can conflict with the legal requirements for a driving license. METHODS: In this single center trial Goldmann perimetric findings in 135 temporal lobe epilepsy surgery procedures were analyzed retrospectively. The data were reviewed with respect to current and former German legal requirements for a driving license. RESULTS: Of the surgical procedures 64 % resulted in visual field defects, 50% of the postoperative visual field findings did not comply with the legal requirements for a driving license and 56% did not comply with those for a heavy goods vehicle driving license. DISCUSSION: A considerable proportion of the epilepsy surgery procedures examined in this study resulted in visual field defects that did not comply with the German legal requirements for driving vehicles. In all cases defects in the center of the visual field proved pivotal.

Perimetry in children: survey of current practices in the United Kingdom and Ireland.

PURPOSE: Visual fields are key functional outcome measures in children with a variety of ophthalmologic disorders. However, reliably assessing fields in children is challenging. We report the findings of a survey of current practices of perimetry in children in the United Kingdom and Ireland. METHODS: An electronic questionnaire was sent to Orthoptic Service Heads in July 2008. Respondents were asked for comments regarding visual field testing in children as well as details of the volume and type of perimetry performed in their units, over a 1-year period. RESULTS: Of the 98 (62%) completed questionnaires, 16 departments reported not testing visual fields in children. In total 3675 subjects under 16 years of age were reported to have undergone perimetry in 1 year, most in units with a ≥ 50% pediatric caseload for orthoptics. A total of 42% of units used static perimetry alone, 11% kinetic, and 47% used a combination of both. CONCLUSION: High numbers of visual field tests are carried out in children in the UK and Ireland annually. Automated perimetry is used predominantly, despite the underlying algorithms having been developed for adult populations. Thus there is a clear need for more research, to ensure that evolving management practices are informed by understanding of the diagnostic accuracy and value of perimetry in children.

A survey of investigations used for the management of glaucoma in hospital service in the United Kingdom.

AIMS: This study surveys the current use of investigations for the management of glaucoma in hospital practice by UK ophthalmologists. METHODS: A total of 1007 questionnaires were posted to all active NHS consultant ophthalmologists. They were asked to indicate the type of hospital (whether university (UTH) or general (DGH) hospital), glaucoma specialist status, and availability and use of automated perimetry, disc photography, HRT, GDx, OCT, and pachymetry. RESULTS: A total of 493 completed questionnaires were received and 469 were analysed: 284 (60.6%) DGH, 185 (39.4%) UTH, 144 (30.7%) glaucoma specialists. There was good availability of automated perimetry (467, 99.6%), disc photography (420, 89.6%), pachymetry (374, 79.7%), OCT (212, 45.2%), HRT (206, 43.9%), and GDx (59, 12.6%). A total of 308 (65.7%) consultants had at least one digital imaging instrument available. The majority of consultants used SAP (347, 74.0%) and SITA-fast (282, 60.1%) for glaucoma suspects, and for monitoring glaucoma (283, 60.3% and 197, 42.0%, respectively). Some used Esterman (155, 33.0%) and Goldmann fields (90, 19.2%) in addition to SAP and SITA-fast for glaucoma suspects. Few consultants used short-wavelength automated perimetry and frequency-doubled perimetry. Of the three imaging tests, HRT was the most commonly used investigation for disc asymmetry, early glaucoma, glaucomatous progression, ocular hypertension, normal tension glaucoma, and unreliable visual fields (P<0.0001). Where pachymeters were available, 333 (89.0%) consultants and 117 (98.3%) glaucoma specialists used pachymetry in glaucoma management. CONCLUSIONS: There was some variation in the use of investigations for the diagnosis and management of glaucoma, reflecting the range of techniques available. SAP, SITA-fast, and pachymetry were the most commonly utilised investigations followed by HRT. Glaucoma specialist status, type of hospital, and presence of research influenced the availability and use of all investigations, except visual fields.

Visual field testing in glaucoma Medicare beneficiaries before surgery.

OBJECTIVE: The standard of care for progressive glaucoma that requires medical or surgical intervention includes visual field (VF) testing at least annually. This study aims to assess how commonly ophthalmologists perform VF testing before planned glaucoma surgery in the Medicare population, and whether variations in conformance occur across demographic and clinical subgroups. DESIGN: Retrospective, observational, population-based analysis. PARTICIPANTS: Thirteen thousand seven hundred fifty-three Medicare beneficiaries. METHODS: Data were obtained from a 5% random sample of Medicare beneficiaries undergoing glaucoma surgery in the United States from 1995 to 1999. The proportion of patients with evidence of at least 1 VF examination in the year before glaucoma surgery was determined. MAIN OUTCOME MEASURE: Rate of VF testing in the year before glaucoma surgery. RESULTS: Overall, 70% of patients had at least 1 VF test in the year preceding glaucoma surgery. This rate was significantly lower (P<0.001) in patients > or =85 years (56%), blacks (64%), patients with race other than white or black (66%), patients with diabetic retinopathy (60%), and patients with bilateral blindness (47%). CONCLUSIONS: The use of VF testing before surgery in glaucoma Medicare beneficiaries is suboptimal relative to the recommended standard of care. Underutilization is of particular concern in blacks, who are at increased risk of glaucomatous damage. Quality-of-care initiatives are needed to facilitate appropriate preoperative evaluations of glaucoma Medicare beneficiaries for glaucoma surgery.

Estudo do limiar foveal através de campo visual computadorizado na angiopatia traumática retiniana (Retinopatia de Purtscher) / Foveal threshold study by computadorized visual field examination in traumatic retinal angiopathy (Purtscher's Retinophaty)

Objetivo: Apresentar a utilidade do estudo do limiar de excitabilidade foveal através da Campimetria Computadorizada na Retinopatia de Purtscher.Local: Departamento de Oftalmo-Otorrinolaringologia, Universidade de Campinas, Campinas, Säo Paulo.Método: O presente estudo relata os achados oftalmoscópicos, angiográficos e campimétricos de um paciente com Retinopatia de Purtscher bilateral, pós-trauma compressivo de tórax.Resultado: A campimetria computadorizada demonstra que, mesmo quando ocorre recuperaçäo total da acuidade visual, pode persistir defeito de funçäo visual por diminuiçäo do limiar de excitabilidade foveal (sensibilidade ao contraste).Conclusäo: A campimetria computadforizada mostrou-se válida na detecçäo da provável causa da queixa visual e no comportamento da evoluçäo da patologia.

An AI approach to dynamic visual field testing.

Visual field test results are crucial to the accuracy and efficiency of diagnosing blinding diseases such as glaucoma. Herein, a method of integrating self-organizing neural networks and empirical heuristics is used to perform visual field tests via a dynamic test strategy, which can lead to a reduction in the number of trials in a perimetric test. Experiments performed using clinical test records show that we are able to reduce by 20% to 30% the number of trials per test without much adverse effect on the accuracy of the tests.

Perimetria computadorizada em pacientes glaucomatosos afácicos / Automated perimetry in aphakic glaucomatous patients

Objetivo: comparar os exames de perimetria computadorizada em pacientes glaucomatosos afácicos usando lentes corretivas convencionais (LCC) e lentes de contato gelatinosas (LC). Métodos: foram selecionados 17 pacientes que já haviam realizado pelo menos dois exames anteriormente, sendo aleatória a escolha daqueles que iniciavam o exame utilizando LCC ou LC. A seleçäo da LC era baseada em critérios específicos e o aparelho utilizado foi o Humphrey Field Analizer 630. Foram analisados dados referentes a idade, sexo, cor, equivalente esférico, sensibilidade foveal, tempo para execuçäo do exame, MD, CPSD, SF e acuidade visual. Para a análise estatística foi utilizado o teste t de Student pareado considerando significativos valores de p menores que 0,05. Resultados: foram excluídos quatro pacientes que apresentaram exames com baixa confiabilidade

Campimetria computarizada con el analizador de campos visuales humphrey: estudio de 350 casos / Computarized perimetry with the of humphrey visual field: study of 350 cases

Se reportan 350 historias médicas de pacientes referidos a una consulta privada en el Centro Médico de Cracas, para evaluación del campo visual mediante campimetria computarizada, entre 1992 y 1995. Un total de 700 ojos fueron evaluados. Se utilizo el analizador computarizado de campos visuales humphrey. Del total de pacientes, 63 por ciento correspondieron al sexo femenino y 37 por ciento masculino. La edad promedio fue de 47,3 años. El motivo de consulta más frecuente fue el control de glucoma (50 por ciento), seguido de pacientes a los cuales no se les preciso el motivo de consulta (24 por ciento) y sospecha de glaucoma (21 por ciento). En cuanto a los hallazgos, 59 por ciento correspondieron a campos visuales normales, seguido de escotomas paracentrales con 13 por ciento, escotoma arcuato en área de Bjerrum con 12 por ciento, aumento de la mancha ciega con un 6 por ciento. 174 pacientes fueron evaluados para control de glaucoma (348 ojos), 59 por ciento con hallazgos positivos (40 por ciento de escotomas arcuatos en áreas de Bjerrum, 32 por ciento de escotomas o defectos paracentrales, 15 por ciento aumento de la mancha ciega). 74 pacientes (148 ojos) fueron evaluados por sospecha de glaucoma, 27 por ciento con hallazgos positivos en la campimetria (39 por ciento de escotomas o defectos paracentrales, 19 por ciento de aumento de la mancha ciega, 13 por ciento escotomas arcuatos en área de Bjerrum, 8 por ciento escalón nasal, 8 por ciento campos visuales tubulares y 8 por ciento de cambios en la sensibilidad retiniana)

[Optimizing the distribution and test locations in statistical perimetry. Preliminary results]. / Optimierung der Verteilung und der Anzahl Testorte in der statischen Perimetrie. Vorläufige Resultate.

BACKGROUND: Are short programs useful to glaucoma-screening? We investigated the concept of Program G1x with Octopus 1-2-3, which permits examination of various numbers of test locations i.e., 16, 32, 45, or all 59 test locations. PATIENTS AND METHODS: Using 99 visual fields of glaucomatous or glaucoma-suspect right eyes, we compared mean defect (MD) and loss variance (LV) of the global visual field with MD and LV of the stages of G1x-program (standard strategy). RESULTS: The results showed that stage 1 of Program G1x underestimated the glaucomatous visual field damage present in the entire field. CONCLUSIONS: Thus, the use of only the first stage (16 test locations) of G1x is not advisable. At least 32 test locations, i.e., stages 1 and 2 of program G1x, are recommended for clinical perimetry.