Quantitative Gesichtsfeldbestimmung (QGFB) zur Beurteilung des Operationserfolges in der Chirurgie der Amotio retinae : Entwicklung einer Methode und Anwendung auf ein Patientenkollektiv
Patients often perceive a detachment of the retina as a deterioration of their visus and/or the reduction of their field of vision. Whereas the measuring of the visus is an established method to assess the results in retinal surgery, the assessment of the field of vision is only of minor importance. The present dissertation introduces a method (the quantitative classification of the field of vision (QCFV)) that allows us to exactly quantify the hand-drawn sketches of the field of vision in the patients’ records. This method was used on a collective of patients who underwent retinal surgery 10 years ago, because it could be expected that the data of these patients’ reports kept in the central archive were as complete as possible. Moreover the results of the quantification of the field of vision as an objective method to assess the success when operating retinal detachment were compared to the findings of visus-measuring and to the fundoscopic assessment of the reattachment of the retina. First a method was developed with which the field of vision could be quantified based on the hand-drawn perimetry sketches in the patients’ reports. The examination of quantitative perimetry with defined, differently configured test-fields proved the method to be reliable. So the method is also suitable for the quantification of the perimetric sketches of the visional field. An exemplary collective of patients was used to prove that the all-over development of visus and the field of vision following an operation of retinal detachment showed similar tendencies (the visus remained unaltered or improved in 67% of all cases, the field of vision expanded in 53%). Although the development of visus and of the field of vision did not differ when the whole collective was looked at, the development of the visus of individual patients was contrary to that of their field of vision in more that 25% of all cases. Therefore the development of visus and that of the field of vision are criteria to be looked at independently with each single patient in order to assess the success of an operation. The results show that the total improvement – or in only a few cases the damage – the patient experiences because of an operation of retinal detachment is not sufficiently described by stating the visus or the fundoscopic results showing the reattachment of the retina. For the patient the discernible changes in his field of vision are a criterion to judge the operational success. So the quantification of the field of vision probably makes an important contribution here. In future the evaluation of different parts of the field of vision should be taken into account.
info:eu-repo/classification/ddc/610, Medizin, Amotio retinae, Ablatio retinae, Perimetrie, Quantitative Gesichtsfeldbestimmung, Operationserfolg, Amotiochirurgie
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