Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.7)
Index Copernicus  – 161.11; MNiSW – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2015, vol. 24, nr 6, November-December, p. 1105–1112

doi: 10.17219/acem/43834

Publication type: review

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Heidelberg Edge Perimeter: The New Method of Perimetry

Kamil Kaczorowski1,B,C,D, Małgorzata Mulak1,A,D,E, Dorota Szumny1,C,D,E, Marta Misiuk-Hojło1,F

1 Department and Clinic of Ophthalmology, Wroclaw Medical University, Poland

Abstract

Glaucoma is an optic nerve neuropathy associated with progressive visual field loss. One of the most frequent eye diseases these days, it is believed to have affected 60 million people worldwide in 2014. Various visual field examination methods are known, from the confrontational test to kinetic and static perimetry. The latest device to access the visual field is the Heidelberg Edge Perimeter (HEP). It is a flicker perimeter, but, unlike others of its kind, it uses a unique stimulus called FDF (Flicker Defined Form). A 5-grade round stimulus is created by reversing the phase of flickering black and white dots, thereby forming illusory outlines. The test uses randomly flickering points in medium illumination (50 cd/m2). The background remains the same during the whole test. Background luminance is 50 cd/m2, the marker showing time is 400 ms, and the frequency is 15 Hz. Current studies show that HEP can detect early visual field loss which remains invisible during a standard visual field test with standard automated perimetry. HEP might also prove useful in the early detection of other diseases connected with visual field loss, for example in neurology.

Key words

glaucoma, visual field, Heidelberg Edge Perimeter (HEP), flicker defined form

References (30)

  1. Weinreb R: Glaucoma Worldwide: A Growing Concern (February 2015). Available from: http://www.glaucoma. org/gleams/glaucoma-worldwide-a-growing-concern.php.
  2. Facts about Glaucoma, National Eye Institute (February 2015). Available from: http://www.nei.nih.gov/health/ glaucoma/glaucoma_facts.asp.
  3. Chen YS, Green CR, Danesh-Meyer HV, Rupenthal ID: Neuroprotection in the treatment of glaucoma – A focus on connexin43 gap junction channel blockers. Eur J Pharm Biopharm 2015.
  4. Park JW, Jung HH, Heo H, Park SW: Validity of the temporal-to-nasal macular ganglion cell-inner plexiform layer thickness ratio as a diagnostic parameter in early glaucoma. Acta Ophthalmol 2015.
  5. El-Danaf RN, Huberman AD: Characteristic patterns of dendritic remodeling in early-stage glaucoma: evidence from genetically identified retinal ganglion cell types. J Neurosc 2015, 35, 2329–2343.
  6. Kerrigan-Baumrind LA, Quigley HA, Pease ME, Kerrigan DF, Mitchell RS: Number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. Invest Ophthalmol Vis Sci 2000, 41, 741–748.
  7. Maddess T, Hemmi JM, James AC: Evidence for spatial aliasing effects in the Y-like cells of the magnocellular visual pathway. Vision Res 1998, 38, 1843–1859.
  8. Hood DC, Kardon RH: A framework for comparing structural and functional measures of glaucomatous damage. Prog Ret Eye Res 2007, 26, 688–710.
  9. White AJ, Sun H, Swanson WH, Lee BB: An examination of physiological mechanisms underlying the frequencydoubling illusion. Invest Ophthalmol Vis Sci 2002, 43, 3590–3599.
  10. Simpson DA, Crompton JL: The Visual Fields: An Interdisciplinary History II. Neurosurgeons and Quantitative Perimetry. J Clin Neurosc 2008, 15, 229–236.
  11. Lanska DJ, von Gräfe A: In: Aminoff MJ, Daroff RB, editors. Encyclopedia of the Neurological Sciences (Second Edition). Oxford: Academic Press 2014, 475–476.
  12. Fankhauser F, Spahr J, Bebie H: Some aspects of the automation of perimetry. Survey of Ophthalmology 1977, 22, 131–141.
  13. Mills R: Perimetry With and Without Automation. Am J Ophthalmol 1987, 104, 197.
  14. Schiefer U, Patzold J, Wabbels B, Dannheim F: Conventional techniques of visual field examination: part 4 Static perimetry: interpretation – perimetric indices – follow-up – perimetry in childhood. Ophthalmologe 2006, 103, 235–254.
  15. Henson DB: Perimetry. In: Dartt DA, editor. Encyclopedia of the Eye. Oxford: Academic Press 2010, 300–306.
  16. Hitchings R: Terminology and Guidelines for Glaucoma (February 2015). Available from: http://www.eugs.org/ eng/EGS_guidelines.asp.
  17. Dannheim F: Flicker and conventional perimetry in comparison with structural changes in glaucoma. Ophthalmologe 2013, 110, 131–140.
  18. Yoshiyama KK, Johnson CA: Which method of flicker perimetry is most effective for detection of glaucomatous visual field loss? Invest Ophthalmol Vis Sci 1997, 38, 2270–2277.
  19. Comer GW: Chapter 15 – Visual-Field Screening and Analysis. In: BenjaminConsultant WJ, Borish IM, editors. Borish’s Clinical Refraction (Second Edition). Saint Louis: Butterworth-Heinemann 2006, 544–618.
  20. Kelly DH: Frequency Doubling in Visual Responses. J Opt Soc Am 1966, 56, 1628–1632.
  21. Horn FK, Tornow RP, Junemann AG, Laemmer R, Kremers J: Perimetric measurements with flicker-defined form stimulation in comparison with conventional perimetry and retinal nerve fiber measurements. Invest Ophthalmol Vis Sci 2014, 55, 2317.
  22. Horn FK, Kremers J, Mardin CY, Junemann AG, Adler W, Tornow RP: Flicker-defined form perimetry in glaucoma patients. Graefe’s Arch Clin Exp Ophthalmol 2014.
  23. Reznicek L, Lamparter J, Vogel M, Kampik A, Hirneiss C: Flicker Defined Form Perimetry in Glaucoma Suspects with Normal Achromatic Visual Fields. Cur Eye Res 2014, 1–7.
  24. Sharma P, Sample PA, Zangwill LM, Schuman JS: Diagnostic Tools for Glaucoma Detection and Management. Surv Ophthalmol 2008, 53, Suppl 6, 17–32.
  25. Mills RP, Hopp RH, Drance SM: Comparison of Quantitative Testing with the Octopus, Humphrey, and Tübingen Perimeters. Am J Ophthalmol 1986, 102, 496–504.
  26. Susanna R Jr, Vessani RM: Staging Glaucoma Patient: Why and How? Open Ophthalmol J 2009, 3, 59–64.
  27. Hasler S, Stürmer J: First experience with the Heidelberg Edge Perimeter® on patients with ocular hypertension and preperimetric glaucoma. Klin Monbl Augenheilkd 2012, 229, 319–322. DOI: 10.1055/s-0031-1299210. Epub 2012 Apr 11.
  28. Prokosch V, Eter N: Correlation between early retinal nerve fiber layer loss and visual field loss determined by three different perimetric strategies: white-on-white, frequency-doubling, or flicker-defined form perimetry. Graefe’s Arch Clin Exp Ophthalmol 2014, 252, 1599–1606.
  29. Shahidi AM, Hudson C, Patel SR, Flanagan JG: The effect of hypercapnia on the sensitivity to flicker defined stimuli. Br J Ophthalmol 2015, 99, 323–328.
  30. Mulak M, Szumny D, Sieja-Bujewska A, Kubrak M: Heidelberg edge perimeter employment in glaucoma diagnosis – preliminary report. Adv Clin Exp Med 2012, 21, 665–670.
© Wroclaw Medical University