Schiefer U, Stercken-Sorrenti G, Dietrich T J, Friedrich M, Benda N
Universitäts-Augenklinik, Abt. II, Tübingen.
Klin Monbl Augenheilkd. 1996 Aug-Sep;209(2-3):62-71. doi: 10.1055/s-2008-1035280.
Conventional automated perimeters usually work with a given set of grids and thus are normally not adapted to individual conditions. This fact restricts efficiency of this method not only for any single examination but also for follow-up studies.
A new method (patent pending) is introduced which superimposes an individual perimetric grid--corrected in respect to orientation, position and size--onto a patient's fundus image. A recently developed software realizes this procedure in a comfortable manner: the digitized fundus image is loaded into the computer by e.g. photo-CD or disc, depicted on a control monitor and mirrored if necessary. Assuming a central fixation, the foveola is translationally shifted to the center of the perimetric grid by the help of a crosshair. The blind spot which has been previously determined with kinetic perimetry is then superimposed onto the optic disc of the fundus image using a rotation and zoom function. In this way, it is possible to adapt the perimetric grid directly to the underlying individual fundus findings: thus, stimuli can be spatially concentrated or more frequently tested in special regions of interest. Additionally, test points can be dragged away from delicate positions to avoid artifacts. Examinations were carried out on a high resolution colour VDU of the Tübingen Electronic Campimeter (TCC). Alternatively, suited bowl perimeters can be used.
In order to test the precision of the superimposing procedure, fundus oriented perimetry was performed to detect angioscotomata in 13 ophthalmologically normal subjects. Using dark stimuli (12'), visual field defects in the expected region, caused by retinal vessels, could be detected in 7 cases (= 54%). The resulting attenuation of differential light sensitivity in this circumscribed region was up to 12 dB.
By means of a morphologically adapted, individual arrangement of stimulus locations fundus-oriented perimetry enables detection of even minute (angio-) scotomata.
传统的自动视野计通常使用给定的一组网格，因此通常无法适应个体情况。这一事实不仅限制了该方法在任何单次检查中的效率，也限制了随访研究的效率。
介绍了一种新方法（专利申请中），该方法将根据方向、位置和大小进行校正的个体视野网格叠加到患者的眼底图像上。最近开发的软件以一种便捷的方式实现了这一过程：数字化的眼底图像通过例如照片光盘或磁盘加载到计算机中，显示在控制监视器上，并在必要时进行镜像。假设中心注视，借助十字准线将黄斑中心凹平移到视野网格的中心。然后，使用旋转和缩放功能将先前用动态视野计确定的盲点叠加到眼底图像的视盘上。通过这种方式，可以直接使视野网格适应潜在的个体眼底检查结果：因此，刺激可以在空间上集中或在特殊感兴趣区域进行更频繁的测试。此外，可以将测试点从敏感位置移开以避免伪像。检查是在图宾根电子视野计（TCC）的高分辨率彩色视频显示器上进行的。也可以使用合适的碗形视野计。
为了测试叠加程序的精度，对13名眼科正常受试者进行了眼底定向视野检查以检测血管暗点。使用暗刺激（12'），在7例（=54%）中检测到由视网膜血管引起的预期区域的视野缺损。在这个限定区域内，差分光敏感度的衰减高达12dB。
通过形态学适应的、刺激位置的个体排列，眼底定向视野检查能够检测到即使是微小的（血管性）暗点。
