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1 General aspects (0)   1.1 Epidemiology (6)   1.2 Population genetics (0)   1.3 Pathogenesis (4)   1.4 Quality of life (6)   1.5 Glaucomas as cause of blindness (1)   1.6 Prevention and screening (3) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (3)   2.2 Cornea (5)   2.3 Sclera (2)   2.4 Anterior chamber angle (2)   2.5 Meshwork (1)     2.5.1 Trabecular meshwork (8)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (0)     2.6.1 Production (2)     2.6.2 Outflow (4)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (0)     2.6.3 Compostion (1)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (0)   2.9 Ciliary body (0)   2.10 Lens (0)   2.11 Vitreous body (0)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (1)   2.13 Retina and retinal nerve fibre layer (11)   2.14 Optic disc (9)   2.15 Optic nerve (4)   2.16 Chiasma and retrochiasmal central nervous system (0)   2.17 Stem cells (0)   2.20 Other (0) 3 Laboratory methods (10)   3.1 Microscopy (1)   3.2 Electron microscopy (5)   3.3 Immunohistochemistry (9)   3.4 Molecular genetics (1)     3.4.1 Linkage studies (16)     3.4.2 Gene studies (2)   3.5 Molecular biology incl. SiRNA (5)   3.6 Cellular biology (4)   3.7 Biochemistry (0)   3.8 Pharmacology (0)   3.9 Pathophysiology (2)   3.10 Immunobiology (0)   3.11 Pharmacogenetics (0)   3.12 Proteomics (1)   3.13 In vivo imaging (0)     3.13.1 Laser Scanning (0)       3.13.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       3.13.1.2 Confocal Scanning Laser Polarimetry (0)     3.13.2 Optical Coherence Tomography (0)       3.13.2.1 Anterior Segment (0)       3.13.2.2 Posterior Segment (0)     3.13.3 RGC Imaging (0)     3.13.4 Other (0)   3.20 Other (0) 4 Tissue culture of ocular cells (0) 5 Experimental glaucoma; animal models (19)   5.1 Rodent (0)   5.2 Primates (0)   5.3 Other (0) 6 Clinical examination methods (0)   6.1 Intraocular pressure measurement; factors affecting IOP (23)     6.1.1 Devices, techniques (0)     6.1.2 Fluctuation, circadian rhythms (0)     6.1.3 Factors affecting IOP (0)   6.2 Tonography, aqueous flow measurement (see also 2.6) (0)   6.3 Biomicroscopy (slitlamp) (0)     6.3.1 Anterior segment (0)     6.3.2 Posterior segment (0)   6.4 Gonioscopy (0)   6.5 Ophthalmoscopy (0)   6.6 Visual field examination and other visual function tests (0)     6.6.1 Conventional manual (1)     6.6.2 Automated (7)     6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (5)   6.7 Electro-ophthalmodiagnosis (6)   6.8 Photography (0)     6.8.1 Anterior segment (0)     6.8.2 Posterior segment (4)   6.9 Computerized image analysis (0)     6.9.1 Laser scanning (22)       6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (0)       6.9.1.2 Confocal Scanning Laser Polarimetry (0)     6.9.2 Optical coherence tomography (11)       6.9.2.1 Anterior (0)       6.9.2.2 Posterior (0)     6.9.5 Other (1)   6.10 Fluorescein (ICG) angiography (0)     6.10.1 Anterior segment (0)     6.10.2 Posterior segment (1)   6.11 Bloodflow measurements (14)   6.12 Ultrasonography and ultrasound biomicroscopy (4)   6.13 Provocative tests (2)   6.19 Telemedicine (2)   6.20 Progression (6)   6.30 Other (0) 8 Refractive errors in relation to glaucoma (0)   8.1 Myopia (0)   8.2 Hypermetropia (0)   8.3 Contact lenses (0)   8.4 Refractive surgical procedures (1)   8.5 Other (0) 9 Clinical forms of glaucomas (0)   9.1 Developmental glaucomas (2)     9.1.1 Congenital glaucoma, Buphthalmos (4)     9.1.2 Juvenile glaucoma (2)     9.1.3 Syndromes of Axenfeld, Rieger, Peters, aniridia (2)     9.1.4 Other (2)   9.2 Primary open angle glaucomas (0)     9.2.1 Ocular hypertension (1)     9.2.2 Other risk factors for glaucoma (10)     9.2.3 Open angle glaucoma with elevated IOP (1)     9.2.4 Normal pressure glaucoma (4)   9.3 Primary angle closure glaucomas (2)     9.3.1 Acute primary angle closure glaucoma (pupillary block) (2)     9.3.2 Chronic primary angle closure glaucoma (pupillary block) (1)     9.3.3 Plateau iris syndrome (0)     9.3.4 Primary angle closure suspect (0)     9.3.5 Primary angle closure (0)     9.3.10 Other (3)   9.4 Glaucomas associated with other ocular and systemic disorders (0)     9.4.1 Steroid-induced glaucoma (4)     9.4.2 Glaucomas associated with disorders of the cornea, conjunctiva, sclera (0)       9.4.2.1 Iridocorneal endothelial syndrome (ICE, incl. irisatrophy) (0)       9.4.2.2 Posterior polymorphous dystrophy (0)       9.4.2.3 Fuchs' endothelial dystrophy (0)       9.4.2.5 Other (0)     9.4.3 Glaucomas associated with disorders of the iris and ciliary body (0)       9.4.3.1 Pigmentary glaucoma (1)       9.4.3.5 Other (0)     9.4.4 Glaucomas associated with disorders of the lens (0)       9.4.4.1 Exfoliation syndrome (5)       9.4.4.2 Glaucomas associated with cataracts (0)       9.4.4.3 Glaucomas associated with lens dislocation (0)       9.4.4.5 Other (0)     9.4.5 Glaucomas associated with disorders of the retina, choroid and vitreous (2)       9.4.5.1 Neovascular glaucoma (3)       9.4.5.5 Other (0)     9.4.6 Glaucomas associated with inflammation, uveitis (5)     9.4.7 Glaucomas associated with ocular trauma (1)     9.4.8 Glaucomas associated with intraocular tumors (0)     9.4.9 Glaucomas associated with elevated episcleral venous pressure (0)       9.4.10 Glaucomas associated with hemorrhage (0)     9.4.11 Glaucomas following intraocular surgery (0)       9.4.11.1 Ciliary block (malignant) glaucoma (0)       9.4.11.2 Glaucomas in aphakia and pseudophakia (1)       9.4.11.3 Epithelial, fibrous, and endothelial proliferation (0)       9.4.11.4 Glaucomas associated with corneal surgery (0)       9.4.11.5 Glaucomas associated with vitreoretinal surgery (1)     9.4.15 Glaucoma in relation to systemic disease (3)     9.4.20 Other (0) 10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy (7) 11 Medical treatment (0)   11.1 General management, indication (10)   11.2 Cholinergic drugs (2)   11.3 Adrenergic drugs (0)     11.3.1 Epinephrine (0)     11.3.2 Thymoxamine, dapiprazole (0)     11.3.3 Apraclonidine, brimonidine (5)     11.3.4 Betablocker (15)     11.3.5 Other (0)   11.4 Prostaglandins (35)   11.5 Carbonic anhydrase inhibitors (4)     11.5.1 Systemic (0)     11.5.2 Topical (8)   11.6 Osmotic treatment (1)   11.7 Treatment of bloodflow (2)   11.8 Neuroprotection (3)   11.9 Gene therapy (3)   11.13 Combination therapy (0)     11.13.1 Betablocker and pilocarpine (0)     11.13.2 Betablocker and carbon anhydrase inhibitor (0)     11.13.3 Betablocker and brimonidine (0)     11.13.4 Betablocker and prostaglandin (0)     11.13.5 Other (0)   11.14 Investigational drugs; pharmacological experiments (6)   11.15 Other drugs in relation to glaucoma (1)   11.16 Vehicles, delivery systems, pharmacokinetics, formulation (0)   11.17 Cooperation with medical therapy e.g. persistency, compliance, adherence (0)   11.20 Other (4) 12 Surgical treatment (0)   12.1 General management, indication (2)   12.2 Laser iridotomy (0)   12.3 Laser iridoplasty (0)   12.4 Laser trabeculoplasty and other laser treatment of the angle (2)   12.7 Surgical iridectomy (0)   12.8 Filtering surgery (3)     12.8.1 Without tube implant (3)     12.8.2 With tube implant or other drainage devices (5)     12.8.3 Non-perforating (10)     12.8.4 Using laser (0)     12.8.5 Other (0)     12.8.10 Woundhealing antifibrosis (6)     12.8.11 Complications, endophthalmitis (6)   12.9 Trabeculotomy, goniotomy (3)   12.10 Cyclodestruction (3)   12.11 Cyclodialysis (0)   12.12 Cataract extraction (1)     12.12.1 Intracapsular (0)     12.12.2 Extracapsular (0)     12.12.3 Phacoemulsification (0)   12.14 Combined cataract extraction and glaucoma surgery (2)     12.14.1 Intracapsular (0)     12.14.2 Extracapsular (0)     12.14.3 Phacoemulsification (2)   12.15 Capsulotomy (0)   12.16 Vitrectomy (0)   12.17 Anesthesia (4)   12.20 Other (2) 13 Therapeutic prognosis and outcome (0)   13.1 Prognostic factors (0)   13.2 Outcome (0)     13.2.1 IOP (0)     13.2.2 Visual field (0)       13.2.2.1 Progression (0)       13.2.2.2 Improvement (0)     13.2.3 Other (0) 14 Costing studies; pharmacoeconomics (2) 15 Miscellaneous (3)

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Abstract #11249 Published in IGR 6-3

A practical approach to measuring the visual field component of fitness to drive

Crabb DP; Fitzke FW; Hitchings RA; Viswanathan AC
British Journal of Ophthalmology 2004; 88: 1191-1196

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AIMS: To determine the level of agreement between merged monocular visual field tests (the integrated visual field) and the binocular Esterman visual field test in classifying patients' visual status for UK legal fitness to drive. To examine the link between these two tests and the useful field of view (UFOV) test, a test which is considered to be a surrogate for the visual capability for safe driving. METHODS: Primary open angle glaucoma patients with bilateral overlapping visual field defects were recruited prospectively. Patients performed the bilateral monocular field tests (to generate the integrated visual field), the Esterman test and the UFOV test on the same visit. Patients were classified as 'pass' or 'fail' by both the integrated visual field and the Esterman test. UFOV risk scores were calculated for each patient. RESULTS: 65 patients were recruited. Substantial agreement was found between the integrated visual field and the Esterman test in classifying patients as 'pass' or 'fail' (κ = 0.69). No patients classified as 'pass' by the integrated visual field test were classified as 'fail' by the Esterman test. Eight patients who were classified as 'pass' by the Esterman test were classified as 'fail' by the integrated visual field test. The UFOV risk characteristics of these eight patients suggested they were more similar to those of the 13 patients who were classified as 'fail' by both the tests, than the 44 patients who were classified as 'pass' by both tests. CONCLUSIONS: The integrated visual field test agrees well with the current method (Esterman) of classifying visual fields with regard to legal fitness to drive in the United Kingdom in patients with glaucoma; it appears superior to the current method in identifying those with reduced fitness to drive as measured by the UFOV. The integrated visual field test could perform a valuable screening or diagnostic role in the assessment of glaucoma patients' fitness to drive.

Dr. D.P. Crabb, School of Science, The Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK. david.crabb@ntu.ac.uk

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Classification:

1.4 Quality of life (Part of: 1 General aspects)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)

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