1.“VisualFields Easy”: an iPad application as a simple tool for detecting visual field defects
Angelane S. Santos ; Evelyn S. Morabe
Philippine Journal of Ophthalmology 2016;41(1):22-26
PURPOSE/OBJECTIVE: This study aims to determine the reliability of the "VisualFields Easy" application in detecting visual field loss among ophthalmology patients; and to determine the sensitivity, specificity, positive predictive and negative predictive values of this examination using the Humphrey Visual Field Analyzer as the gold standard.
METHODS: This is an analytical study that enrolled subjects requiring visual field examination as part of the comprehensive evaluation of their ophthalmologic condition. Each subject was tested using the standard automated Humphrey Field Analyzer (Carl Zeiss Meditec, Inc., Germany) with the 30-2 Swedish Interactive Thresholding Algorithm (SITA) and the "VisualFields Easy" application (background = 10 cd / m2 ; size V target; 16-dB stimulus) loaded in an iPad 2 ver. 8.3. The print outs of each test were then interpreted independently by the principal investigator and verified by a glaucoma specialist as positive or negative for visual field defects and computation for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were done.
RESULTS: The study included 137 eyes of 77 patients, 52 (68%) females and 25 (32%) males, age ranging from 18 to 82 years with a mean (SD) of 58 (+ 14) years. The mean test duration for the standard Humphrey perimetry was 7 minutes 50 seconds (SD + 0.08s), and 3 minutes 21 seconds (SD + 0.01s) for the "VisualFields Easy". Correlations of False Positives and False Negatives between the 2 tests were p=0.02 and p=0.03 respectively and that there was no statistically significant difference between the reliability parameters of the two tests. There were a total of 74 positives and 63 negatives visual field defects for the Humphrey. These were considered as the True Positive (TP) and True Negative (TN) values. For the "VisualFields Easy", there were 67 positives and 70 negatives. The results of the "VisualFields Easy" were plotted against the Humphrey perimetry. Sensitivity was computed at 91% and specificity at 100%. Likewise the Positive Predictive Value (PPV) was computed to be 100% and the Negative Predictive Value (NPV) was computed at 90%.
CONCLUSION: The "VisualFields Easy" application is a quick, easily accessible and fairly reliable way of measuring visual field abnormalities, both for glaucoma and neuro-ophthalmology patients. The application is not intended to replace standard automated perimetry machines, but it may have a role in detecting, documenting and monitoring visual field defects in low resource settings where visual field tests are not available.
Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Visual Field Tests ; Visual Fields ; Ophthalmology ; Glaucoma ; Sensitivity And Specificity ; Tetrahymenina
2.Prevalence of graves ophthalmopathy among patients with thyroid disease
Erwin D. Palisoc ; Evelyn S. Morabe ; Paulo Ma. N. Pagkatipunan
Philippine Journal of Ophthalmology 2010;35(1):32-
Objective:
This study determined the prevalence of Graves ophthalmopathy among
thyroid-disease patients at a tertiary government hospital.
Methods:
Patients with thyroid disease seen at a tertiary hospital from February to
September 2007 were enrolled. All patients underwent ophthalmologic
examination consisting of visual-acuity testing; exophthalmometry;
examination for presence of lid retraction, lid lag, and lateral flare; globe
position; external-ocular-muscle-movement grading; corneal light reflex; and
direct funduscopic examination.
All clinical findings were recorded and data were analyzed. Chi square and
Fisher’s exact tests determined the association of gender and age to the
different ocular signs and symptoms. One-way analysis of variance (ANOVA)
compared the average number of ocular symptoms among the different age
groups.
Results:
A total of 121 patients, 20 males and 101 females, with thyroid disease were
evaluated. 47.93% had Graves ophthalmopathy, occurring more frequently
among patients aged between 30 and 49 years. The most common signs were
eyelid retraction, proptosis, and lid lag.
Conclusion
Graves ophthalmopathy occurs frequently among patients with thyroid
disease, especially those more than 30 years of age.
Graves Ophthalmopathy
;
Graves Disease
;
Exophthalmos
;
Thyroid Diseases
3.Efficacy of vitamin supplementation in preventing color vision abnormalities among patients undergoing DOTS for Tuberculosis
Jan Michael R. Reyes ; Anne Marfe L. Tan ; Melizza T. Ramirez ; Roland B. Bagnes ; Evelyn S. Morabe ; Emerson M. Cruz
Philippine Journal of Ophthalmology 2013;38(1):50-55
Objective:
To determine if vitamin supplementation can prevent the development of color vision abnormalities
in patients taking ethambutol as part of DOTS for tuberculosis (TB).
Methods:
A randomized, placebo-controlled, single-blind clinical trial was conducted among newly diagnosed
category-1 TB patients enrolled in DOTS health centers in the third district of Manila from June 2011 to August
2012. Before starting therapy, the participants underwent a complete eye evaluation including baseline color vision
tests using the Ishihara Color Vision Plates (Ishihara), Farnsworth Panel D-15 (FD 15), and Lanthony Desaturated
D-15. Only subjects who passed the three color vision tests were included in the study. They were divided into 2
groups: Group A received vitamin supplementation and Group B received a placebo. Follow-up color vision testing
was done monthly for 3 months.
Results:
There were 105 patients included in the study, 77 males and 28 females, age ranging from 16 to 68 years with a
mean of 37 years. Forty three (43) patients received vitamin supplementation (group A) and 62 received placebo (group
B). After one month of DOTS, 5 of 43 patients (11. 6%) in group A and 10 of 62 patients (16.1%) in group B developed
color vision abnormalities, detected only with the Lanthony Desaturated test. The absolute risk reduction (ARR) of
color vision abnormalities by vitamin supplementation was 4.5%, with the number needed to treat (NNT) of 23. After
the second month of therapy, ARR was 7.4% and NNT was 14. ARR was highest in the third month at 8.3%, with
a corresponding decreased NNT of 12. Among patients who developed color vision abnormalities, reversal of the
abnormalities was observed in 80% of 5 subjects in group A, and 40% of 10 patients in group B. By the third month of
treatment, all in group A already had normal color vision, while 40% in group B still showed abnormal color vision.
Conclusion
This study showed that vitamin supplementation was effective in reducing the risk of, and in reversing
cases of, color vision abnormalities among patients undergoing DOTS therapy for tuberculosis.
Tuberculosis
;
Ethambutol
;
Color Vision
;
Optic Neuritis
4.Prevalence of color-vision deficiency among male high-school students
Emerson M. Cruz ; Herma Grace S. Cerdana ; Ann Margaret B. Cabrera ; Chanda B. Garcia ; Evelyn T. Santos-Morabe ; Ma. Lourdes R. Nañ ; agas
Philippine Journal of Ophthalmology 2010;35(1):20-24
Objective This study determined the prevalence of color-vision deficiency among male high-school students in a public school. Methods Male high-school students were screened for color-vision deficiency using 6 plates of the Ishihara pseudoisochromatic plates. All students with one or more errors were reexamined at a later date with the full 15 Ishihara plates and the Farnsworth D15 (FD15) test. A detailed history was taken and an ocular examination was conducted. Students who identified less than 10 plates correctly on the FD15 were classified as color-deficient and underwent the Farnsworth Munsell 100 hue (FM 100) test. The results were statistically analyzed. Results A total of 1,258 male high-school students, aged 12 to 16 years, were included in the study, 122 of whom failed the screening test. Of these, 106 completed the 15 Ishihara plates. Sixty-five failed and were classified as color-visiondeficient, of which 64 (98%) were deutans. Deutan was also the most common deficiency determined using the FD15 (78.95%) and FM100 (44.19 %) hue tests. Conclusion The prevalence of color-vision deficiency among male students in a public high school was 5.17% (65/1,258). The most common deficiency was the deutan type.
Color Vision Defects