Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition[J]. 眼科实践与研究新进展, 2024,4(1):39-44.
Linyan Wang, Davin C. Ashraf, Michael Deiner, et al. Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition[J]. AOPR, 2024,4(1):39-44.
Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition[J]. 眼科实践与研究新进展, 2024,4(1):39-44. DOI: 10.1016/j.aopr.2024.01.007.
Linyan Wang, Davin C. Ashraf, Michael Deiner, et al. Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition[J]. AOPR, 2024,4(1):39-44. DOI: 10.1016/j.aopr.2024.01.007.
Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition
摘要
Abstract
ObjectiveTo investigate whether functional upper eyelid malposition is associated with unrecognized deficits in automated perimetry among glaucoma patients by examining patients undergoing eyelid surgery who had not been identified as requiring eyelid taping during glaucoma field testing.MethodsIn this retrospective pre-post study
an automated database search followed by manual chart review was used to identify eligible patients from January 2012 to March 2020. Included patients had reliable visual field testing within two years before and after functional upper blepharoplasty or ptosis repair and no comorbid ocular diagnoses. As part of routine practice
glaucoma visual field technicians taped patients with pupil-obstructing eyelid malposition; taped examinations were excluded from analysis. Clinical and demographic characteristics
mean deviation
and pattern standard deviation were evaluated within a two year period before and after eyelid surgery.ResultsThe final analysis included 60 eyes of 38 patients. Change in visual field parameters after eyelid surgery did not reach statistical significance in crude or adjusted analyses. Among patie
nts with ptosis
the margin reflex distance-1 was not associated with change in mean deviation after surgery (Pearson R
2
= 0.0061;
P
= 0.700). Five of 17 eyes excluded from analysis due to unreliable pre-operative visual fields demonstrated substantial improvement after surgery.ConclusionsFunctional upper eyelid malposition does not appear to cause spurious visual field abnormalities among glaucoma patients with reliable visual fields who were determined not to require eyelid taping at the time of their visual fields. Unreliable visual fields could be a sign of eyelid interference in this population.
1 Y.-C. Tham, X. Li, T.Y. Wong, et al.Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis Ophthalmology, 121 (2014), pp. 2081-2090, 10.1016/j.ophtha.2014.05.013
2 C.G. De Moraes, J.M. Liebmann, L.A. LevinDetection and measurement of clinically meaningful visual field progression in clinical trials for glaucoma Prog Retin Eye Res, 56 (2017), pp. 107-147, 10.1016/j.preteyeres.2016.10.001
3 A. Rabiolo, E. Morales, J.H. Kim, et al.Predictors of long-term visual field fluctuation in glaucoma patients Ophthalmology (2019), 10.1016/j.ophtha.2019.11.021
4 M. Yu, C. Lin, R.N. Weinreb, et al.Risk of visual field progression in glaucoma patients with progressive retinal nerve fiber layer thinning: a 5-year prospective study Ophthalmology, 123 (2016), pp. 1201-1210, 10.1016/j.ophtha.2016.02.017
5 K.V. Cahill, E.A. Bradley, D.R. Meyer, et al.Functional indications for upper eyelid ptosis and blepharoplasty surgery: a report by the american academy of ophthalmology Ophthalmology, 118 (2011), pp. 2510-2517, 10.1016/j.ophtha.2011.09.029 Epub 2011 Oct 22
6 L.M. Provencher, E.M. Shriver, W.L. AlwardPtosis masquerading as progression of severe glaucoma JAMA ophthalmology, 135 (2017), Article e172788-e88, 10.1001/jamaophthalmol.2017.2788
7 A.S. Kosmin, P.K. Wishart, M.K. BirchApparent glaucomatous visual field defects caused by dermatochalasis Eye, 11 (Pt 5) (1997), pp. 682-686, 10.1038/eye.1997.177
8 R. Nesher, Y. Almog, L. Gorck, et al.A new method for eyelid elevation in glaucoma patients with ptosis during automated perimetry testing J Glaucoma, 16 (2007), pp. 260-263, 10.1097/IJG.0b013e31802ff87c
9 K.E. Kim, J.W. Jeoung, D.M. Kim, et al.Long-term follow-up in preperimetric open-angle glaucoma: progression rates and associated factors Am J Ophthalmol, 159 (2015), pp. 160-168, 10.1016/j.ajo.2014.10.010 e1-2
10 Center for medicare and medicaid services. Blepharoplasty - medical policy article. Medicare coverage database. Available at: https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=52837&ver=15&DocID=A52837&bc=gAAAABAAAAAA&. Accessed September 23, 2021.
11 B.W. Gillespie, D.C. Musch, K.E. Guire, et al.The collaborative initial glaucoma treatment study: baseline visual field and test–retest variability Investigative ophthalmology & visual science, 44 (2003), pp. 2613-2620, 10.1167/iovs.02-0543
12 M. YaqubVisual fields interpretation in glaucoma: a focus on static automated perimetry Community Eye Health, 25 (2012), p. 1 PMID: 23840075, but no
13 Introduction of humphrey field analyzer 3 (hfa3). Available at: https://www.zeiss.fr/content/dam/Meditec/international/ifu/documents/hfa3/current/2660021166131_a_artwork.pdf. Accessed September 23, 2021.
14 R core teamR: A Language and Environment for Statistical Computing R foundation for statistical computing, vienna, austria (2020) Available at: www.R-project.org/, Accessed 23rd Sep 2021
15 H. Wickham, W. Chang, L. HenryGgplot2: Elegant Graphics for Data Analysis (2012) Computer software] Retrieved from
16 D.R. Meyer, J.V. Linberg, S.R. Powell, J.V. OdomQuantitating the superior visual field loss associated with ptosis Arch Ophthalmol, 107 (1989), pp. 840-843, 10.1001/archopht.1989.01070010862030
17 L.J. Saunders, F.A. Medeiros, R.N. Weinreb, L.M. ZangwillWhat rates of glaucoma progression are clinically significant? Expet Rev Ophthalmol, 11 (2016), pp. 227-234, 10.1080/17469899.2016.1180246
18 J.W. Cho, K.R. Sung, S.C. Yun, et al.Progression detection in different stages of glaucoma: mean deviation versus visual field index Jpn J Ophthalmol, 56 (2012), pp. 128-133, 10.1007/s10384-011-0110-7
19 I.S. Yalvac, M. Altunsoy, S. Cansever, et al.The correlation between visual field defects and focal nerve fiber layer thickness measured with optical coherence tomography in the evaluation of glaucoma J Glaucoma, 18 (2009), pp. 53-61, 10.1097/IJG.0b013e318179f751
20 M. Ng, P.A. Sample, J.P. Pascual, et al.Comparison of visual field severity classification systems for glaucoma J Glaucoma, 21 (2012), pp. 551-561, 10.1097/IJG.0b013e31821dac66