Is static perimetry a viable test for negative dysphotopsia?

Netherlands: Whole threshold static perimetry with a Goldmann size III stimulation up to 60 degrees of eccentricity did not reveal any appreciable variations between measurements taken before and after intraocular lens (IOL) replacement or between patients with negative dysphotopsia and pseudophakic controls, a recent study has revealed.

The findings of the study, published in Optometry and Vision Science, indicates that this type of static perimetry cannot be used as a quantitative objective test for diagnosis or follow-up of patients with negative dysphotopsia.

There is a clinical requirement for a quantifiable test to reliably detect negative dysphotopsia, especially as the diagnosis is currently based on subjective descriptions provided by patients. This study rejects static perimetry as an appropriate evaluation tool in the search for a clinical test to objectify the shadow perceived in negative dysphotopsia. Furthermore, the purpose of this study was to test the use of static perimetry in the objective assessment and follow-up of negative dysphotopsia.

In 27 patients with negative dysphotopsia and 33 pseudophakic controls, peripheral 60-4 Full Threshold visual field tests were done. In addition, 11 patients with negative dysphotopsia underwent the test again following intraocular lens exchange. The entire peripheral visual field and the mean peripheral visual field from 50 to 60 degrees eccentricity were evaluated in patients and controls, as well as pre-and postoperatively in IOL exchange patients.

The key findings of this study were as follows:

1. There were no significant variations in peripheral vision fields from 30 to 60 degrees between patients with negative dysphotopsia and pseudophakic controls.

2. The median of the peripheral visual field from 50 to 60 degrees was 20.0 dB in the negative dysphotopsia group compared to 20.1 dB in the control group.

3. Although 82% of patients treated with IOL exchange reported subjective improvement in their negative dysphotopsia complaints after surgery, there were no significant alterations in their total peripheral visual field or mean peripheral visual field from 50 to 60 degrees.

In conclusion, the study brought out the fact that static perimetry of this sort cannot be utilized as a quantitative objective test for the diagnosis or follow-up of patients experiencing negative dysphotopsia.

Reference:

Rozendal, L. R. W., van Vught, L., Luyten, G. P. M., & Beenakker, J.-W. M. (2022). The Value of Static Perimetry in the Diagnosis and Follow-up of Negative Dysphotopsia. In Optometry and Vision Science: Vol. Publish Ahead of Print. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/opx.0000000000001918