Unrecognized visual field loss is caused by a range of blinding eye conditions as well as serious brain diseases. The commonest cause of asymptomatic visual field loss is glaucoma. No screening tools have been proven cost-effective. Damato Multifixation Campimetry Online (DMCO), an inexpensive online test, has been evaluated as a future cost-beneficial tool to detect glaucoma. To further validate DMCO, this study aimed to test DMCO in a preselected population with neurological visual field loss. Methods: The study design was an evaluation of a diagnostic test. Patients were included if they had undergone surgery for epilepsy during 2011-2014, resulting in visual field loss. They were examined with DMCO and results were compared with those obtained with the Humphrey Field Analyzer (30:2 SITA-Fast). DMCO sensitivity and specificity were estimated with 95% confidence intervals. Results: The cohort comprised 40 patients (25 female and 15 male) with a mean age of 39 years (range 17-60 years). The mean visual acuity was >1.0 and all eyes had an intraocular pressure <21 mm Hg. Sensitivity and specificity of DMCO compared to the reference standard were 72.7 and 96.3%, respectively. Conclusions: DMCO detects moderate-to-severe homonymous quadrantanopia; it can be useful in settings where the current practice is confrontation visual field examination, and where standard conventional perimetry is not available.

1.
Tuulonen A: Cost-effectiveness of screening for open angle glaucoma in developed countries. Indian J Ophthalmol 2011;59(suppl): S24-S30.
2.
Resnikoff S, Felch W, Gauthier T, Spivey B: The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200,000 practitioners. Br J Ophthalmol 2012;96:783-787.
3.
Varma R, Vajaranant TS, Burkemper B, Wu S, Torres M, Hsu C, et al: Visual impairment and blindness in adults in the United States: demographic and geographic variations from 2015 to 2050. JAMA Ophthalmol 2016;134:802-809.
4.
Damato B, Groenewald C: Multifixation campimetry on line: a perimeter for the detection of visual field loss using the Internet. Br J Ophthalmol 2003;87:1296-1298.
5.
Ianchulev T, Pham P, Makarov V: Peristat: A computer-based perimetry self-test for cost-effective population screening of glaucoma. Curr Eye Res 2005;30:1-6.
6.
Bruun-Jensen J: Visual field screening with a laptop computer system. Optometry 2011;82:519-527.
7.
Olsen AS, Alberti M, Serup L, Cour ML, Damato B, Kolko M: Glaucoma detection with Damato Multifixation Campimetry Online. Eye 2016;30:731-739.
8.
Boon PA, Williamson PD, Fried I, Spencer DD, Novelly RA, Spencer SS, et al: Intracranial, intraaxial, space-occupying lesions in patients with intractable partial seizures: an anatomoclinical, neuropsychological, and surgical correlation. Epilepsia 1991;32:467-476.
9.
Hughes TS, Abou-Khalil B, Lavin PJ, Fakhoury T, Blumenkopf B, Donahue SP: Visual field defects after temporal lobe resection: a prospective quantitative analysis. Neurology 1999;53:167-172.
10.
Nilsson D, Malmgren K, Rydenhag B, Frisén L: Visual field defects after temporal lobectomy - comparing methods and analysing resection size. Acta Neurol Scand 2004;110:301-307.
11.
Mengesha T, Abu-Ata M, Haas KF, Lavin PJ, Sun DA, Konrad PE, et al: Visual field defects after selective amygdalohippocampectomy and standard temporal lobectomy. J Neuroophthalmol 2009;29:208-213.
12.
Heijl A, Patella V, Bengtsson B: The Field Analyzer Primer: Effective Perimetry, ed 4. Dublin (CA), Carl Zeiss Meditec, 2012.
13.
Society EG: Terminology and Guidelines for Glaucoma, ed 4. Savona, PubliComm, 2014.
14.
Kedar S, Zhang X, Lynn MJ, Newman NJ, Biousse V: Congruency in homonymous hemianopia. Am J Ophthalmol 2007;143:772-780.
15.
TDR Diagnostics Evaluation Expert Panel: Evaluation of diagnostic tests for infectious diseases: general principles. Nat Rev Microbiol 2010;8:S17-29.
16.
Walsh T: Visual Fields. Oxford, Oxford University Press, 2010.
17.
Schiefer U: Visual field defects - essentials for neurologists. J Neurol 2003;250:407-411.
18.
Ellish N, Higginbotham E: Evaluating a visual field screening test for glaucoma: how the choice of the gold standard affects the validity of the test. Ophthalmic Epidemiol 2001;8:297-307.
19.
Thomas D, Thomas R, Muliyil J, George R: Role of frequency doubling perimetry in detecting neuro-ophthalmic visual field defects. Am J Ophthalmol 2001;131:734-741.
20.
Wall M, Neahring RK, Woodward KR: Sensitivity and specificity of frequency doubling perimetry in neuro-ophthalmic disorders: a comparison with conventional automated perimetry. Invest Ophthalmol Vis Sci 2002;43:1277-1283.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.