Reliability of Semiautomated Kinetic Perimetry (SKP) and Goldmann Kinetic Perimetry in Children and Adults With Retinal Dystrophies

Abstract

Purpose To investigate the precision of visual fields (VFs) from semiautomated kinetic perimetry (SKP) on Octopus 900 perimeters, for children and adults with inherited retinal degenerations (IRDs). Goldmann manual kinetic perimetry has long been used in the diagnosis and follow-up of these patients, but SKP is becoming increasingly common. Octopus VFs (OVFs) and Goldmann VFs (GVFs) were both mapped on two occasions. Methods Nineteen females and 10 males with IRDs were tested on OVFs and GVFs, with two targets per test (V4e and one smaller target). Tests were performed in the same (randomized) order at two visits about 1 week apart. The VFs were digitized to derive isopter solid angles. Comparisons, within and between visits, were performed with paired t -tests and Bland-Altman plots. Results Median age was 20 years (range, 7–70; 10 participants aged ≤17 years old). There were no significant differences in solid angles between OVFs and GVFs ( P ≥ 0.06) or between the two visits' solid angles on either perimeter ( P ≥ 0.30). Between-visit test–retest variability for GVFs and OVFs was similar ( P ≥ 0.73), with median values of approximately 9% to 13%. Overall variability was lower for children than adults (medians of 7.5% and 12.8%, respectively). Conclusions Octopus SKP and Goldmann perimetry produced VFs of similar size and variability. Translational Relevance Our study indicates that SKP provides a viable alternative to traditional Goldmann perimetry in clinical trials or care involving both children and adults with IRDs.

CRB1-Associated Retinal Dystrophies: A Prospective Natural History Study in Anticipation of Future Clinical Trials

“…26 However, these changes should be interpreted with caution, as greater variability in visual field measurements is predicted in patients with more advanced stages of BCVA-or visual field-based impairment. [36][37][38] This is evidently demonstrated in our cohort as 4 severe visually impaired patients showed improvements up to 90% in visual fields areas at follow-up, in absence of intervention. Goldmann kinetic perimetry assumes stable and foveal fixation, which is not always the case in patients with severe RP such as in the current study.…”

RPGR-Associated Dystrophies: Clinical, Genetic, and Histopathological Features

“…Previous studies have shown that the hyper-AF ring correlates with the presence of the EZ band and demarcates the transition between healthy and affected retina [2,22,23]. The constriction of this hyper-AF ring in RP indicates disease progression, whereas, conversely, the expansion of the hyper-AF ring in CRD patients suggests disease progression [2,24].…”

Monitoring progression of retinitis pigmentosa: current recommendations and recent advances

“…[28] The reliability of the GVF is however highly operator dependent, and prone to erroneous results from variable target speeds, particularly for small and dim targets. [29,30] The original Goldmann perimeter is no longer produced, and has been replaced by semi-automated kinetic perimetry (SKP) devices with standardization of target velocity and test pattern. The SKP Octopus 900 (Haag Streit AG, Koeniz, Switzerland) has shown strong agreement with the GVF, and is considered a viable alternative to the GVF in clinical trials and for clinical care.…”

“…The SKP Octopus 900 (Haag Streit AG, Koeniz, Switzerland) has shown strong agreement with the GVF, and is considered a viable alternative to the GVF in clinical trials and for clinical care. [30,31] Studies testing the quantitative analysis of OCT as a structural measure for disease progression have shown that perception of the Goldmann I4e isopter correlates with retinal areas showing an intact inner segment ellipsoid zone. [32] The usefulness of the Goldmann visual field as a clinical trial outcome measure however is limited by its high test-retest variability and its operator dependence.…”