ArticleAmerican journal of ophthalmology case reports2025
Smaller spot sizes show bitemporal visual field defects missed by standard Humphrey perimetry.
Article in American journal of ophthalmology case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To compare the sensitivity of Humphrey visual field (HVF) tests using different stimulus spot sizes for the detection of early visual field defects in a patient with known chiasmal compression. Observations: A 21-year-old man with a suprasellar tumor compressing the optic chiasm had multiple normal 24-2 HVF tests using a stimulus size III test spot over 5 years. Subsequent ganglion cell complex (GCC) analysis on optical coherence tomography (OCT) showed ganglion cell layer + inner plexiform layer (GCL + IPL) thinning in the macula. Therefore, HVF testing was performed using smaller test spots. Size I and II spots both revealed a superior temporal field defect in each eye that was missed by the standard size III spot. Conclusions and importance: These findings demonstrate that HVF testing using stimulus size I or II spots can reveal a visual field defect that was missed when using a standard size III spot. We therefore recommend routinely performing HVF testing in patients with known chiasmal compression with a stimulus size I or II spot, when testing with a stimulus size III spot is negative.
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