A comparison of unweighted and fluctuation-weighted indices (within the central 28� of glaucomatous visual fields measured with the Octopus automated perimeter)

Funkhouser, A.; Fankhauser, Franz

doi:10.1007/bf00128955

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…Comparing our results with other studies, it is noteworthy that many studies use 'mean deviation' of the Humphrey field analyzer (HFA, Humphrey Instruments, San Leandro, California, USA). However, given that differences between 'mean and 'mean defect' are negligible, they can be used interchangeably (Monsalve et al 2017;Funkhouser & Fankhauser 1990). Nevertheless, it should be kept in mind that with increasing loss in the VF, the MD increases (becomes more positive) while the mean deviation decreases (becomes more negative).…”

Section: Discussionmentioning

confidence: 99%

“…However, given that the differences between ‘mean deviation’ and ‘mean defect’ are negligible, they can be used interchangeably (Monsalve et al. 2017; Funkhouser & Fankhauser 1990). Nevertheless, it should be kept in mind that with increasing loss in the VF, the MD increases (becomes more positive) while the mean deviation decreases (becomes more negative).…”

Section: Discussionmentioning

confidence: 99%

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Effects of glaucoma surgery on visual field progression in open‐angle glaucoma considering the floor effect

Schlatter

Rauchegger

Schmid

et al. 2021

Acta Ophthalmologica

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Purpose: The aim of this retrospective analysis was to investigate whether trabeculectomy (TRAB) and XEN ® Gel Stent implantation (XEN)both filtrating surgery techniquescan slow down the deterioration of visual field (VF) parameters considering the floor effect, which could lead to a misestimation of pre-and postoperative VF rate of progression (ROP). Methods: Included in this study were patients with open-angle glaucoma, who underwent either TRAB or XEN ® gel stent implantation and who had at least three VF tests before and after surgery, over an observation period of 13 years. The annual ROP of the mean defect (MD) and the square root of loss variance (sLV) were calculated with two different censoring thresholds: by censored regression and by ordinary least squares regression (OLSR). In addition, the diagnostic range of sLV was calculated. Results: 48 eyes of 39 glaucoma patients were included in the study. The annual rate of MD progression was significantly reduced by filtering surgery when calculating the yearly ROP using OLSR (p = 0.006) and by censoring values exceeding a precalculated cut-off of 14.20 dB (p = 0.041) and a cut-off from the literature of 15.00 dB (p = 0.028). On average, the MD was impacted by a significant floor effect of 14.20 dB (95% CI: 12.83-15.56), corresponding to 17.7/59 absolute defects or 29.9% of the whole VF. When applying both OLSR and censored regression, the annual rate of sLV progression did not show a significant difference. The sLV showed a diagnostic boundary at a MD of 15.78 dB. Conclusion:This study shows that filtering surgery can reduce the progression of VF in patients with open-angle glaucoma, especially those whose disease develops aggressively. This is valid even if the floor effect in advanced cases is compensated by censored regression. On average, the ROP of MD is affected by a significant floor effect at about 29.9% absolute loss of the whole VF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of glaucoma surgery on visual field progression in open‐angle glaucoma considering the floor effect

Schlatter

Rauchegger

Schmid

et al. 2021

Acta Ophthalmologica

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“…This research tool served later as a basis for the development of the Octopus program G1 designed for clinical application [14–16]. We established normal values, accounting for age [17] and topography [18], introduced visual field indices to quantify visual field defects [16, 19, 20], compared the index ‘mean defect’ with the ‘mean deviation’ that was introduced later [21] and found some information profit by retests [22], but not by probability weighting [23, 24]. We separated diffuse from local damage with the cumulative defect curve [25], called the Bebie curve [26], and compared it with other methods to quantify diffuse damage [27].…”

Section: Visual Field Testing and Ocular Blood Flowmentioning

confidence: 99%

The discovery of the Flammer syndrome: a historical and personal perspective

Flammer

Konieczka

2017

EPMA Journal

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This review describes the clinical and basic research that led to the description of Flammer syndrome. It is narrated from a personal perspective. This research was initiated by the observation of an increased long-term fluctuation of visual fields in a subgroup of glaucoma patients. As these patients had strikingly cold hands, peripheral blood flow was tested with a capillary microscopy, and vasospastic syndrome (VS) was diagnosed. Further studies on these patients revealed frequently weakened autoregulation of ocular blood flow and increased flow resistivity in retroocular vessels. Their retinal vessels were more rigid and irregular and responded less to flickering light. Holistic investigation demonstrated low blood pressure, silent myocardial ischaemia, altered beat-to-beat variation, altered gene expression in the lymphocytes, slightly increased plasma endothelin level and increased systemic oxidative stress. This combination of signs and symptoms was better described by the term primary vascular dysregulation (PVD) than by VS. Subsequent studies showed additional symptoms frequently related to PVD, such as low body mass index, cold extremities combined with slightly increased core temperature, prolonged sleep onset time, reduced feelings of thirst, increased sensitivity to smell and also for certain drugs and increased retinal venous pressure. To better characterise this entire syndrome, the term Flammer syndrome (FS) was introduced. Most subjects with FS were healthy. Nevertheless, FS seemed to increase the risk for certain eye diseases, particularly in younger patients. This included normal-tension glaucoma, anterior ischaemic optic neuropathy, retinal vein occlusions, Susac syndrome and central serous chorioretinopathy. Hereditary diseases, such as Leber’s optic neuropathy or retinitis pigmentosa, were also associated with FS, and FS symptoms and sings occurred more frequent in patients with multiple sclerosis or with acute hearing loss. Further research should lead to a more concise definition of FS, a precise diagnosis and tools for recognizing people at risk for associated diseases. This may ultimately lead to more efficient and more personalised treatment.

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A comparison of five methods for estimating general glaucomatous visual field depression

Funkhouser

Fankhauser

Hirsbrunner

1992

Graefe's Arch Clin Exp Ophthalmol

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The separation of local and diffuse visual field loss is important for evaluating the nature and extent of glaucomatous visual field damage. Here, five automated methods for estimating diffuse loss in glaucomatous visual fields (as measured with the Octopus G1 program) are compared. Four are taken from the published literature, and one is introduced in this investigation. It is shown that the new index (here called diffuse loss) provides the best agreement with a value determined using a more empirical approach.

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A comparison of unweighted and fluctuation-weighted indices (within the central 28� of glaucomatous visual fields measured with the Octopus automated perimeter)

Cited by 5 publications

References 10 publications

Effects of glaucoma surgery on visual field progression in open‐angle glaucoma considering the floor effect

Effects of glaucoma surgery on visual field progression in open‐angle glaucoma considering the floor effect

The discovery of the Flammer syndrome: a historical and personal perspective

A comparison of five methods for estimating general glaucomatous visual field depression

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