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Abstract #6383 Published in IGR 3-2
Should we use short-wavelength automated perimetry to test glaucoma patients?
Caprioli JAmerican Journal of Ophthalmology 2001; 131: 792-794
In this editorial, the author critically discusses the pros and cons of short-wavelength automated perimetry. In his introduction, he discusses the rationale for early detection of glaucomatous disease. He mentions the methods for detecting both structural and functional abnormalities. He repeats that the veracity of the early findings regarding the large ganglion cells has not been established beyond doubt. The editorial really centers on a paper by Demirel and Johnson on the incidence and prevalence of a short-wavelength perimetry deficit in ocular hypertensive patients. In that large study, the short-wavelength defects at the beginning were present in 9.4% of patients compared with 1.4% of patients with standard automated perimetry. Most of the patients with short-wavelength perimetry had their defects on retesting, whereas this was the case in less than half the patients with standard automated perimetry. He stresses the data provided on the rates of progression. These were similar for both techniques used, even though short-wavelength perimetry may detect visual function disturbances at an earlier stage. The author discusses some methodological problems of short-wavelength perimetry, such as the high level of noise and the length of the test, and furthermore, the necessity for correction for lens density. Therefore, he feels that short-wavelength perimetry may be less useful for detecting progressive changes in more advanced glaucoma than for detecting early signs of damage. Another interesting question is whether short-wavelength abnormalities precede measurable structural change or the reverse. The author believes that the latter may be the case. Quite an interesting approach is the statement that, if the goal of therapy is to protect the quality of vision of patients, then the rate of progression would be much more important to measure accurately. This does not seem a particular advantage of short-wavelength perimetry. Finally, the author notes that the use of short-wavelength perimetry in all patients with lens changes may not be advisable. He suggests that this technique is particularly useful for the younger glaucoma suspects with multiple risk factors, as an indication of whether to start treatment.
Dr J. Caprioli, Jules Stein Institute, 100 Stein Plaza, Los Angeles, CA 90095, USA. caprioli@ucla.edu
Classification:
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
