Abstract

SO.16.09

Optimised visual field diagnostics in children with the use of fundus controlled perimetry

Kristina Kuoliene1, Christoph Friedburg2, Melanie Jäger2, Birgit Lorenz2
1University of Vilnius, Vilnius, Lithuania; 2Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Gießen und Marburg GmbH, Standort Gießen, Gießen

Objective
Conventional static perimetry in children is often impossible due to limited cooperation, lack of practice and, most importantly, limited duration of target fixation. In fundus controlled perimetry, stimulation occurs only when the device can identify the central fundus thereby avoiding malfixation.
Methods
40 children (46 eyes) aged 4 to14 years were examined using the Nidek Technologies MP-1 microperimeter. The central retina was continuously tracked. Goldmann III stimuli were randomly presented in preselected patterns (0° - 18°) and a 4-2 dB strategy was applied to determine threshold. Maximum attenuation of the stimulus is limited to 20 dB.  Experienced examiners supervised the automatic test and adjusted the orientation of the MP-1 as required to maintain tracking.
Results
Static fundus controlled perimetry was possible in 35 patients (40 eyes) and an acceptable result was acquired in 93%. The youngest successfully examined patient was 5 years old. The total mean fixation stability within 2° and 4° were 74.2% and 92.2%, respectively. Dilating pupils significantly aided projection of the stimuli and increased the time window suitable for target presentation.
Conclusions
Examination with the MP-1 was feasible in a large number of children under regular clinical conditions. Since this examination can be delegated, since a short fixation can be used for measurements, and since deviations can be corrected accordingly, fundus controlled perimetry can potentially be superior to central Goldmann Perimetry. Therefore, fundus controlled perimetry is a promising examination method that could improve central visual field examination in children with visual field defects.

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