New Light on Glaucoma

Heidelberg Edge Perimeter

Heidelberg Edge Perimeter

The Heidelberg Edge Perimeter (HEP)

performs innovative functional testing
of the visual system. Not only Standard
Automated Perimetry (SAP), but also a
NEW early detection test - Flicker-Defined
Form (FDF; 1,2).

HEP is a 2 in 1 perimeter!

Now you have the best of both worlds –

whether you are screening for disease or
whether you are monitoring established
glaucoma patients.

HEP meets all state-of-the-art requirements

for static perimetry in a space-saving,
compact design.

1
Rogers-Ramachandran D. et al.; Vision Research 1998;38:71-77.
2
Flanagan JG. et al.; Perimetry Update 1994/1995; 405-409.
Stage-Specific Perimetry
Visual field testing remains the main diagnostic tool to SAP
provide information about a patient’s visual function,
quality of vision and quality of life.
Functional testing supports clinicians in early disease
detection, staging of disease or trend analysis in progressive
glaucoma.
FDF
2-in-1 perimetry with HEP offers the most appropriate
test for each stage of disease.
It allows you to offer the right stimulus to your patient at
the appropriate stage of disease.

Flicker-Defined-Form Perimetry
The FDF stimulus or Contour “Edge” Illusion has been shown
to be useful for detecting visual field loss in patients with
early glaucoma(3). A 5-degree circular stimulus is created
by a phase reversal of black and white dots that flicker in
counter-phase to the background dots. The flicker creates an
+ =
illusionary edge contour that the patient perceives as a gray
patch or circle against the mean luminance background(4). Phase 1 Phase 2 “Edge” Illusion
FDF Perimetry has been proven to correlate to structural
defects detected by HRT or SPECTRALIS® OCT(5,6).

Standard Automated Perimetry low sensitivity absolute VF defect

Maximum stimulus luminance HFA SAP: 3183 cd/m2 (10,000 asb)
Maximum stimulus luminance HEP SAP: 100 cd/m2 ( 314.2 asb)

Standard Automated Perimetry (SAP) or white-on-white

perimetry is best suited for patients with moderate to severe eter d/m²) 3183 cd/m²
on Perim
progressive disease and thereby offers continuity of care. Projecti n inc
c e rease (c
mina
The HEP monitor-based system offers full dynamic range s size, lu
t stimulu
100 cd/m² Constan 0.43°
perimetry and has proven to deliver equivalent results to a
projection-type perimeter(7,8). The HEP offers a unique W/W
Perimetry using a Goldmann size III target for the 40 dB to 16 0.43° 100 cd/m²
dB range. From 15 dB to 0 dB, the stimulus size is increased Stimulu
s size in
crease
following the Goldmann equation to give perceptual (°), con
stant lu
minanc
equivalence(9). This unique approach enables full-range HEP e

Standard Automated Perimetry and ensures good test-retest 2.7°

characteristics.

3
Fingeret M. et al.; ARVO 2010; Program/Poster: 5509/A564.
4
Quaid P. et al.; Vision Research 2005;45:1075-1084.
5
Butty Z. et al.; ARVO 2011; Program/Poster: 4145/A598.
6
Ho Y.-H. et al.; ARVO 2011; Program/Poster: 5076/A56.
7
Goren D. et al.; ARVO 2010; Program/Poster: 4335.
8
Ferreras A. et al.; ARVO 2011; Program/Poster: 5524/A325.
9
Anderson D.R. and Patella V.M.; Automated Static Perimetry. 2nd Edition (1999). Mosby. pp 26-27.
 FDF SAP III SAP V Standard Tests

10-3 10-2 10-2 HEP is a monitor-based perimeter designed to test central and
peripheral vision. It offers a full set of standard tests for the
central 10°, 24° and 30° visual field as well as an extension to
24-2 24-2 24-2 the periphery up to 60° (100 points).

30-2 30-2 30-2

30-60N 30-60N

30-60 30-60

Thresholding Strategies
The Heidelberg Edge Perimeter uses three different kinds
of Adaptive Staircase Thresholding Algorithm (ASTA)
strategies covering a broad range of applications.

The ASTA Standard algorithm for baseline examinations

uses a 4-2-2 staircase approach as well as neighboring test
target information and a quick termination methodology
to reduce test time.

UNIQUE:
ASTA Follow-Up further reduces the test time during follow-
up examinations. Results of previous tests are used to seed
each location of the field. Test time reductions resulting in a
3 minute test are typically achieved while maintaining the
same test sensitivity.
Examination Report – Single Eye and OU Report

ASTA Fast is a short test protocol advised for

patients expected to be “within normal limits” or those who
have previously shown unusual levels of fatigue. Starting
values are based on age-matched normal values.

HEP also offers time-saving screening tests. The screening

strategy balances the demand for a quick visual field assess-
ment with the need for sufficient accuracy.

Choose your favorite report format; either single eye

OS-OD or OD-OS or the OU report in portrait or
landscape format.
Trend Analysis

HEP´s Functional Change Analysis (FCA) applies existing

knowledge of the random variability of visual field analyses
and flags progressive visual field loss that exceeds the normal
level of repeatability. FCA is compatible with ASTA Standard
and ASTA Follow-Up examinations.
The FCA is the first trend analysis to provide information on
significant change in probability maps for Total Deviation as
well as for Pattern Deviation.
Easy-to-read symbols are used to indicate a worsening visual
field and assist with interpretation.
FCA is the only trend analysis that can either monitor both
slight changes in early disease with FDF Perimetry as well as
long-term follow-up with SAP in advanced glaucoma patients. Examination Report –
FCA - Trend and Event
Analysis Report

Structure-Function Integration
The integration of Heidelberg Engineering devices through
the joint HEYEX software platfom allows for combined
analysis of structural damage of optic nerve head (ONH)
or retinal nerve fiber layer (RNFL) and visual field defects.
Data from HRT or SPECTRALIS® OCT can be linked with HEP
visual field results to arrive at a conclusive glaucoma diagnosis
more easily.
■ All relevant information on one report
■ Automatically generated in HEYEX
■ Improved time and patient management
Examination Reports - Joint Structure-Function Display -
■ Facilitates patient education HRT or OCT and VF

Connectivity
The Heidelberg Eye Explorer (HEYEX) software platform
provides flexible solutions from a solo practice to a large
clinic environment. The integrated patient database
facilitates storage and management of image files from all
existing Heidelberg Engineering devices, such as
SPECTRALIS, HRT and HEP. Network-viewing software
gives easy and reliable access to patient image files on most
networked computers supporting seamless consultation and
diagnosis.
■ HEYEX compatible with SPECTRALIS, HRT and HEP
■ Centralized data storage
■ Online data access
■ Easy retrieval and viewing
■ Office efficiency

Image Courtesy Dr. Fritz Dannheim, Germany and Dr. Victor Spears, Canada.
 93402-001.E11 © Heidelberg Engineering GmbH

Corporate Headquarters
Heidelberg Engineering GmbH · Tiergartenstr. 15 · 69121 Heidelberg · Germany
Tel. +49 6221 6463-0 · Fax +49 6221 646362

UK Office
Heidelberg Engineering Ltd. · Breakspear Park Suite F · Breakspear Way · Hemel Hempstead · Hertfordshire HP2 4TZ
Tel. +44 1442 345 370 · Fax: +44 1442 345 001

US Office
Heidelberg Engineering, Inc. · 1808 Aston Avenue, Suite 130 · Carlsbad, CA 92008
Tel. +1 760-536-7000 · Fax +1 760-536-7100

www.HeidelbergEngineering.com