title: Detection of Visual Field Loss in Pituitary Disease: Peripheral Kinetic Versus Central Static.
abstract: Visual field assessment is an important clinical evaluation for eye disease and neurological injury. We evaluated Octopus semi-automated kinetic peripheral perimetry (SKP) and Humphrey static automated central perimetry for detection of neurological visual field loss in patients with pituitary disease. We carried out a prospective cross-sectional diagnostic accuracy study comparing Humphrey central 30-2 SITA threshold programme with a screening protocol for SKP on Octopus perimetry. Humphrey 24-2 data were extracted from 30-2 results. Results were independently graded for presence/absence of field defect plus severity of defect. Fifty patients (100 eyes) were recruited (25 males and 25 females), with mean age of 52.4 years (SD = 15.7). Order of perimeter assessment (Humphrey/Octopus first) and order of eye tested (right/left first) were randomised. The 30-2 programme detected visual field loss in 85%, the 24-2 programme in 80%, and the Octopus combined kinetic/static strategy in 100% of eyes. Peripheral visual field loss was missed by central threshold assessment. Qualitative comparison of type of visual field defect demonstrated a match between Humphrey and Octopus results in 58%, with a match for severity of defect in 50%. Tests duration was 9.34 minutes (SD = 2.02) for Humphrey 30-2 versus 10.79 minutes (SD = 4.06) for Octopus perimetry. Octopus semi-automated kinetic perimetry was found to be superior to central static testing for detection of pituitary disease-related visual field loss. Where reliant on Humphrey central static perimetry, the 30-2 programme is recommended over the 24-2 programme. Where kinetic perimetry is available, this is preferable to central static programmes for increased detection of peripheral visual field loss.
authors.affiliation: Department of Health Services Research.
authors.forename: Fiona J
authors.initials: FJ
authors.lastname: Rowe
authors.affiliation: Department of Biostatistics, University of Liverpool Liverpool UK.
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cheyne
authors.affiliation: Department of Biostatistics, University of Liverpool Liverpool UK.
authors.forename: Marta
authors.initials: M
authors.lastname: García-Fiñana
authors.affiliation: Department of Ophthalmology, Aintree University Hospital NHS Foundation Trust Liverpool UK and.
authors.forename: Carmel P
authors.initials: CP
authors.lastname: Noonan
authors.affiliation: Department of Orthoptics, Salford Royal NHS Foundation Trust Manchester UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Howard
authors.affiliation: Department of Ophthalmology, Aintree University Hospital NHS Foundation Trust Liverpool UK and.
authors.forename: Jayne
authors.initials: J
authors.lastname: Smith
authors.affiliation: Department of Orthoptics, Salford Royal NHS Foundation Trust Manchester UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Adeoye
keywords: Humphrey; kinetic; octopus; perimetry; pituitary; static