Features of visual field changes in patients with degenerative optic neuropathies

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Abstract

BACKGROUND: Degenerative optic neuropathies are one of the leading causes of irreversible blindness. The most accessible and effective methods of their early diagnosis are standard and non-standard perimetry.

AIM: The aim of this study is to identify the features of visual field changes in patients with degenerative optic neuropathies.

MATERIALS AND METHODS: The study involved 56 patients (97 eyes) with degenerative optic neuropathies, divided into 3 groups, and the control group consisted of 60 healthy individuals (60 eyes). In addition to the standard ophthalmological examination, all subjects underwent Humphrey visual field testing and Frequency Doubling Technology (FDT) perimetry in the author’s modification.

RESULTS: In patients with degenerative optic neuropathies, the sensitivity level of both FDT perimetry strategies turned out to be significantly higher in the detection of primary open-angle glaucoma than in that of multiple sclerosis, and the specificity level was 2 times higher than that of the Humphrey visual field testing. The data of the variance analysis showed that the results of FDT perimetry reliably separate patients with degenerative optic neuropathies from healthy individuals, but it is not always possible to determine the type of optic neuropathy.

CONCLUSIONS: Both threshold strategies of FDT perimetry are more effective in detecting optic neuropathy in primary open-angle glaucoma than in multiple sclerosis in terms of sensitivity. They have higher specificity than Humphrey perimetry, which indicates the advantage of FDT perimetry in separation between healthy people and patients with degenerative optic neuropathies, and not only of glaucomatous nature. The moderate and reliable correlation between the MD indices of all three strategies of perimetry indicates the expediency of their integrated use for early diagnosis of primary open-angle glaucoma.

About the authors

Irina L. Simakova

Kirov Military Medical Academy

Author for correspondence.
Email: irina.l.simakova@gmail.com
ORCID iD: 0000-0001-8389-0421
SPIN-code: 3422-5512

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, 21 Botkinskaya st., Saint Petersburg, 199044

Alexei N. Kulikov

Kirov Military Medical Academy

Email: alexey.kulikov@mail.ru
ORCID iD: 0000-0002-5274-6993
SPIN-code: 6440-7706

MD, Dr. Sci. (Medicine), Professor

Russian Federation, 21 Botkinskaya st., Saint Petersburg, 199044

Irina A. Tikhonovskaya

Kirov Military Medical Academy

Email: irenpetrova@yandex.ru
ORCID iD: 0000-0002-7518-8437

MD, Cand. Sci. (Medicine)

Russian Federation, 21 Botkinskaya st., Saint Petersburg, 199044

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Supplementary files

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2. Fig. 1. Mean values of the scotomata amount (n ≥ 2 at p < 2, 1 and 0.5%), with 95% confidence intervals according to the results of the of computer strategies data: a — 24-2 HFA II; b — FDT-16; с — FDT-64

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3. Fig. 2. Mean values of the global MD index with 95% confidence intervals according to the results of the of computer strategies data: a — 24-2 HFA II; b — FDT-16; c — FDT-64

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4. Fig. 3. Correlation between the values of the global MD index according to the data of the threshold strategies FDT-16 and 24-2 HFA II (a); FDT-64 and 24-2 HFA II (b) in patients with the early stage of primary open-angle glaucoma

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5. Fig. 4. Correlation between the values of the global MD index according to FDT-16 and 24-2 HFA II data (a), FDT-64 and 24-2 HFA II (b) in multiple sclerosis patients with a history of retrobulbar neuritis

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6. Fig. 5. Correlation between the values of the global MD index according to FDT-16 and 24-2 HFA II data (a); FDT-64 and 24-2 HFA II data (b) in patients with multiple sclerosis without history of retrobulbar neuritis

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7. Fig. 6. Conclusion on the results of the central visual field testing of the patient P. with multiple sclerosis performed using the threshold version of the author’s modification of the FDT perimetry: FDT-16 (a) and FDT-64 (b)

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8. Fig. 7. Conclusion on the results of the central visual field testing of the patient D. with multiple sclerosis (location of scotomata in the central area), performed using the threshold strategy FDT-64

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9. Fig. 8. Conclusion on the results of the central visual field testing of the patient V. with an early stage of primary open-angle glaucoma performed using the threshold version of the author’s modification of the FDT perimetry: FDT-16 (a) and FDT-64 (b)

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