Basic and clinical aspects of modern perimetry

: Clinical perimetry has made a remarkable advance in the last 40 years and many new automated perimeters and sophisticated techniques are now available. We developed a Central Field Screener, O-II, an automated perimeter, ATS-85, and a central critical fusion frequency (CFF)-meter. First, reappraisal of the clinical significance of manual kinetic perimetry was made in comparison with automated light threshold perimetry in the diagnosis of retinitis pigmentosa and chiasmal tumors. We concluded that manual kinetic perimetry was the basis of clinical perimetry and superior to automated static light threshold perimetry in some cases. Secondly, automated static flicker perimetry was performed with Octopus 1-2-3 and a software package developed by us. We found that automated static flicker perimetry was far superior to automated static light threshold perimetry in the detection of early changes of glaucomatous field defects, especially in cases of immature senile cataract. We also confirmed that measurement of CFF was essential in the diagnosis of optic neuritis and diseases of chiasmal syndrome. Dissociation of central vision and central CFF was observed in many cases of optic neuritis and inverse dissociation of central vision and central CFF was seen in some cases of Leber's disease.