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Frequenzverdopplungsperimetrie

Neue Methode zur Untersuchung glaukomatöser Gesichtsfeldausfälle

Frequency-doubling technology

A new method for determining glaucomatous visual field defects

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Zusammenfassung

Das Glaukom ist eine Erkrankung, bei der der Verlust retinaler Ganglienzellen zu Gesichtsfeldausfällen bis hin zur Erblindung führt. Bis heute gilt die Weiß-auf-Weiß-Perimetrie als Goldstandard zur Gesichtsfelduntersuchung. Jedoch müssen rund 30–50% der retinalen Ganglienzellen verloren sein, bevor mittels Weiß-auf-Weiß-Perimetrie ein Defekt erkannt werden kann. Daraus erwuchs das Bestreben, neue Techniken zu entwickeln, mittels derer Gesichtsfelddefekte früher erkannt werden können als durch die herkömmliche Methode. Die Frequenzverdopplungsperimetrie (FDT-Perimetrie) wird hierbei als vielversprechende Technik angesehen. Mit ihr soll es möglich sein, eine Subpopulation der Netzhautganglienzellen (sog. Mγ-Zellen) anzusprechen, die offenbar besonders früh vom Glaukom betroffen sind und eine niedrige Redundanz aufweisen. Das Matrix-FDT wurde als FDT-Gerät der zweiten Generation entwickelt, um die räumliche Auflösung von Gesichtsfelddefekten weiterhin zu verbessern. Ziel dieses Artikels ist die Vorstellung der Frequenzverdopplungsperimetrie sowie die Diskussion der derzeitigen Datenlage hinsichtlich Vergleichsstudien von FDT mit Standard-Weiß-auf-Weiß-Perimetrie.

Abstract

Glaucoma is a disease in which death of retinal ganglion cells is associated with loss of visual function. The gold standard for visual field testing has been standard automated perimetry (SAP). However, up to 30–50% of retinal ganglion cells must be lost before a scotoma is detected with SAP. Therefore, investigators have been interested in finding diagnostic techniques that would allow earlier detection of visual field loss than that detected by standard white-on-white perimetry. Frequency-doubling technology (FDT) has been suggested as a promising technique that may detect glaucomatous ganglion cell damage earlier than SAP by targeting a sparsely spaced subsystem of Mγ retinal ganglion cells where cell damage is less masked by redundancy. The second generation of FDT perimetry, the Matrix FDT, was released with the intention of improving the spatial resolution of visual field defects. In this article we present FDT and discuss data that compare FDT with standard white-on-white perimetry.

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  1. Universitäts-Augenklinik Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland

    J. Lamparter, A. Schulze & E.M. Hoffmann

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  1. J. Lamparter
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  2. A. Schulze
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  3. E.M. Hoffmann
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Correspondence to J. Lamparter.

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Lamparter, J., Schulze, A. & Hoffmann, E. Frequenzverdopplungsperimetrie. Ophthalmologe 106, 709–713 (2009). https://doi.org/10.1007/s00347-009-1957-6

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