EXTENDED REPORT

Frequency doubling technology perimetry in non-arteritic ischaemic optic neuropathy with altitudinal defects

C A Girkin¹, G McGwin, Jr² and J DeLeon-Ortega¹

¹ Optic Nerve Imaging Center of the University of Alabama at Birmingham, and Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, AL, USA
² Department of Ophthalmology, School of Medicine and Department of Epidemiology and International Health, School of Public Health, University of Alabama at Birmingham, AL, USA

Correspondence to:
Correspondence to:
Christopher Girkin MD
Department of Ophthalmology, University of Alabama at Birmingham, Callahan Eye Foundation Hospital, 700 South 18th Street, Suite 601, Birmingham, AL, 35233, USA; cgirkin{at}uabmc.edu

Aim: To determine if frequency doubling technology perimetry (FDT) is more sensitive to optic nerve injury in non-arteritic ischaemic optic neuropathy (NAION) than standard automated perimetry (SAP).

Methods: Charts from 18 patients (20 eyes) with NAION with altitudinal defects who underwent a complete neuro-ophthalmic examination, SAP, and FDT were reviewed. The extent of damage as determined by SAP, FDT, and clinical estimation of the regional extent of optic disc pallor was compared. 10 subjects (20 eyes) with normal ocular examinations and full appearing optic nerve heads were included as a control group.

Results: FDT demonstrated more extensive visual field defects in the relatively intact hemifield on SAP (proportion of locations at 5% or worse in the total deviation plot was 8.7% (SD 6.2%) for SAP and 38.3% (39.5%) for FDT p<0.0027). 16 of 20 eyes with altitudinal NAION demonstrated diffuse optic disc pallor. 11 of these eyes with diffuse pallor demonstrated significant defects in both hemifields using FDT, while only two eyes demonstrated diffuse damage using SAP. Correspondence between the extent of optic disc pallor and the extent of visual scotoma was higher for FDT (85%) than with SAP (40%).

Conclusion: FDT appears more sensitive to axonal injury reflected by the extent of optic disc pallor in altitudinal NAION than SAP and in some patients reveals visual dysfunction in the hemifield that appeared relatively uninvolved when evaluated using SAP.

Abbreviations: FDT, frequency doubling technology; NAION, non-arteritic ischaemic optic neuropathy; SAP, standard achromatic perimetry; SITA, Swedish Interactive Thresholding Algorithm

Keywords: frequency doubling technology perimetry; non-arteritic ischaemic optic neuropathy

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