Heidelberg Egde Perimeter – nowy standard perymetrii?
Heidelberg Edge Perimeter – a New Standard of Perimetry?
Małgorzata Mulak1, Dorota Szumny2, Kamil Kaczorowski1, Marta Misiuk-Hojło1
1 Katedra i Klinika Okulistyki Uniwersytetu Medycznego im. Piastów Śląskich we Wrocławiu
Kierownik: prof. dr hab. n. med. Marta Misiuk-Hojło
2 Katedra i Zakład Farmakologii Uniwersytetu Medycznego im. Piastów Śląskich we Wrocławiu
Kierownik: prof. dr hab. n. med. Adam Szeląg
Summary: Introduction: Glaucoma is an optic nerve neuropathy and one of the most common causes of the reduction in visual acuity in highly developed countries. One of the basic diagnostic methods for glaucoma is a visual field test. The European Glaucoma Society recommends performing Standard Automated Perimetry (computer and static), but other kinds of techniques and devices are used more and more often. One of them is the Heidelberg Edge Perimeter, which utilises a unique light stimulus (Flicker-Defined Form), created using two overlapping phases of flickering black and white dots, which creates a contour illusion. Flicker-Defined Form stimulates random magnocellular retinal cells (M), which are the first to be damaged in early glaucoma stages. Another advantage of the apparatus is the fact that it can be coupled with the Heidelberg Retina Tomograph, which makes it possible to obtain an image relating the structure of the eye to its function.
Purpose: The aim of this study is to present a lesser-known and unconventional visual field examination method using the Heidelberg Edge Perimeter.
Methods: Literature data have been used for the comparison of conventional static perimetry and unconventional perimetry using the Flicker-Defined Form stimulus.
Results: The study results quoted indicate that Heidelberg Edge Perimeter detects scotomas earlier than conventional perimetry.
Discussion: Relatively little literature data confirms that the new examination technique in question enables detection of early visual field defects not yet visible in conventional perimetry. A correlation with imaging techniques has also been stated. The method can be helpful in the diagnostics and differentiation of early glaucoma stages. The literature data say the examination is short, but the test turned out to be tiring, especially for elderly patients. Due to the peculiarity of the stimulus the effect of learning is particularly important.
Conclusion: Heidelberg Edge Perimeter can prove a useful apparatus in the diagnostics and monitoring of glaucoma, although currently there is too little evidence to state the superiority of this method over conventional static perimetry. The patient’s adaptation to a new kind of stimulus is of particular relevance.
Słowa kluczowe: jaskra, pole widzenia, Heidelberg Edge Perimeter – HEP, nadciśnienie oczne, perymetria.
Keywords: glaucoma, visual field, Heidelberg Edge Perimeter – HEP, ocular hypertension, perimeter.