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Twinfield® 2

Uncompromising versatility

  • Static Automated Perimetry
  • Kinetic Perimetry
  • Adaptability
  • Highlights
  • Functions
  • Reliable Measuring Methods
  • Glaucoma
  • Technical Data
  • Contact

The Right Tool for All

The OCULUS Twinfield® 2 provides you with the very best of our more than 50 years of experience in the perimetry area. This device measures the full field of vision using both automatic, static perimetry and automatic or manual kinetic examinations. The Twinfield® 2 received the express recommendation of the German Ophthalmology Society (DOG) for expert assessment perimetry.

  • Static Automated Perimetry: For precise measurement of the central visual field.
  • Kinetic Perimetry: Automated and manual examinations made easy while conforming to the Goldmann standard.
  • Tradition is on your Side: Benefits from more than 50 years of experience gathered by the manufacturer of the world‘s first static perimeter and technology “Made in Germany”.
  • Adaptability: A wide range of test programs and special, flexibly customisable examinations using the OCULUS Twinfield® 2.
OCULUS Twinfield® 2

Functions

Static Perimetry

The Twinfield® 2 performs fast and versatile automatic static examinations to measure the central field of vision with a high degree of accuracy. In the macular area, the precision is increased even more by a considerable densification of the test points, and the periphery can be tested using a suitable test grid.

The modular setup of the examination programs guarantees that the Twinfield® 2 perimeter can be adapted to meet all clinical research and daily practice requirements.
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Kinetic Perimetry

Exact adherence to the Goldmann Standard allows the Twinfield® 2 to be used for assessment perimetry purposes. Automation of the kinetic examinations increases the reproducibility of the test. Fast and comprehensive testing of the entire field of vision testing is achieved by linking the fully automatic kinetic tests with static testing methods.

Improved Diagnostic Reliability

Additional processes improve the diagnostic reliability of perimetric examinations conducted with the Twinfield® 2 perimeter. Re-examination of areas of concern independent of the test point grid and remote observation of the patient’s eye increase the reliability of the findings; the expert system Glaucoma Staging Program (GSP) provides valuable support in the analysis of the findings.

The Examination Programs

The pre-defined test programs of the Twinfield® 2 perimeter have been set up in such a way that you can easily perform the examinations that you require most often. Whether glaucoma, age-related macular degeneration, neurological diseases – appropriate examinations are available for them all.

Furthermore, the modular setup of these programs enable you to create custom test processes, as all available test point grids can be conveniently combined with all OCULUS test strategies. You can thus extend the comprehensive standard program series to meet your own particular requirements.
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The OCULUS Test Strategies

To gain as much information in the shortest possible time – this principle has always been heeded in the development of all OCULUS test strategies. The SPARK Strategy incorporates data from more than 90 000 diagnoses in a matter of minutes to give precise and stable measurements, especially in Glaucoma detection, diagnosis and progression analysis.

The OCULUS Fast Threshold achieves a similar performance with clever improvements to the classic 4-2 step method. And since exact numeric values of the perception threshold do not, in many cases, show any priority, the multiple suprathreshold strategies available in the Twinfield® 2 perimeters offers a faster and more comfortable alternative.
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The OCULUS Test Point Grid

Optimally selected examination areas significantly contribute to meaningful visual field findings. The Twinfield® 2 perimeter provides comprehensive, pre-defined test point grids, which cover all areas ranging from the macula area to the entire field of vision.

Grids with a higher density of test points in the center, which take account of the physiology of the retina, are the trademark of the Twinfield® 2. Grids with uniform, orthogonally distributed test points along with other grids, such as the Esterman grid, complete the list of available examination areas.
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Results Printout

The measuring results of the Twinfield® 2 perimeter are summarized in the standardized results printout. For threshold-determining examinations, all clinically relevant data are recorded and are shown in various different depictions whereas for suprathreshold tests, only a single informational overview is printed.

Definitely my all-round favourite!

For glaucoma care, macular examinations and neurological cases as well as for formulation of expert opinions, the OCULUS Twinfield® 2 offers me optimal examination methods and meets all my specific needs. The great versatility of Twinfield® 2 coupled with its robustness and reliability has provided a valuable addition to my practice.

Reliable Measuring Methods

Up to the challenge

Static automated perimetry

  • Pre-defined programs allow for time-saving, easy-to perform examinations during daily clinical practice.
  • A comprehensive set of orthogonal, physiological and freely customizable test grids in combination with suitable testing strategies offer a high degree of flexibility for your examinations.
  • Re-examinations of clinically significant areas performed independent of the test pattern in use increase reliability of findings.
OCULUS Twinfield® 2 - Greyscale representation of findings
OCULUS Twinfield® 2 - Isopter representation of a kinetic examination

Kinetic perimetry

  • Strict fulfilment of the Goldmann standard along with free manual positioning and movement of the stimulus allows for truly manual kinetic examinations such as are required for formulating legal expert opinions.
  • For semi-automated kinetic tests the starting position and direction of the stimulus are set manually. Movement of the stimulus at a constant speed is computer-controlled and thus examiner-independent. This increases reproducibility of findings.
  • Fully automated kinetic tests make it possible to perform rapid tests of the periphery which can be combined with static tests for fast screening of the entire visual field

Focus on Glaucoma

Measurement – Assessment – Progression

The first step: screening for glaucoma
Speed, precision and reliability: the SPARK threshold strategy
Beyond field indices: Glaucoma Staging Program (GSP)
Efficient progression analysis: Threshold Noiseless Trend (TNT)
Using perimetry for glaucoma screening customarily involves performing supra-threshold examinations of the central visual field. In addition, the Twinfield® 2 perimeter provides a pre-defined combination of a static and a kinetic test designed to obtain an overview of the entire visual field in a minimum of time. The device software makes it easy to create customised screening programmes using different test patterns which can be adapted to special requirements.
The SPARK1) strategy is based on statistical relationships between threshold values found for different locations in the glaucomatous visual field. These relationships have been derived from more than 90 000 perimetric examinations, providing high statistical significance and allowing for fast and very precise threshold measurements in the central visual field. The four-phase structure of SPARK makes it a versatile tool for clinical practice:

  • SPARK Precision is the full-fledged version of SPARK. Comprehensive visual field examinations of glaucoma patients can be performed in just 3 minutes per eye. Averaging the results over all four phases ensures a high degree of reliability and reproducibility for improved progression analysis.
  • SPARK-Quick is the perfect strategy for follow-up and screening examinations. The procedure only takes 90 seconds per eye.
  • SPARK Training is ideal for patient training. This 40-second measurement can also be used for screening.

The SPARK strategy is an optional addition to the Twinfield® 2. It is fine-tuned for use in clinical examinations of glaucoma patients. Modified versions of the above procedures, called SPARK-N, are available for suspected cases of neurological pathology.

This novel evaluation module performs a thorough assessment of individual visual field findings using modern algorithms of pattern recognition. Besides its unique contribution to early glaucoma diagnosis, GSP2) can substantiate the clinical evaluation of test results.

GSP classification is optimized to reproduce expert opinions on glaucoma. The GSP database includes correlations with the entire clinical picture (including structural changes). This information enables GSP to evaluate the degree of risk for the presence of different glaucoma stages on the basis of visual field findings.

Intuitive green-yellow-red colour coding helps in fast and reliable interpretation of the findings. The striking novelty of GSP consists in its capability to identify both glaucoma suspect patients and patients with possible pre-perimetric glaucoma using nothing but measured threshold values.

The TNT3) software module objectively evaluates changes over time in visual field results. Combined with the fast SPARK strategy it increases considerably the sensitivity for detecting progression in early glaucoma.

  • TNT displays a concise report of the progression analysis with a summary of the most relevant parameters (MD slope, p-values, etc.).
  • TNT can distinguish between cases of diffuse and focal progression based on the value of the “Focality Index” (FI).
  • TNT uses multiple statistical criteria in establishing progression.
  • TNT presents age-related predictions on the visual field.

Device
Glaukom-Screening Glaucoma Staging Program (GSP) - GSP-Analyse eines präperimetrischen Befundes Threshold Noiseless Trend (TNT) Progressionsanalyse

Title

Description

1) M. González de la Rosa, J Glaucoma 2013
2) D. Wroblewski et al, Graefes Arch Clin Exp Ophthalmol 2009
3) M. González de la Rosa and M. González-Hernandez, Br. J. Ophthalmol. 2011; V.T Diaz-Aleman et al., Br. J. Ophthalmol. 2009

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Technical Data

Static Perimetry

Programs: Pre-defined glaucoma, macula, neurological and screening tests;
Static-kinetic screening; user-defined tests
Strategies: Threshold strategies: OCULUS Fast Threshold, Full Threshold, CLIP
Optional: SPARK strategy
Age-adapted supra-threshold screening
(2-zone, 3-zone, quantify defect, OCULUS Class strategy)
Test patterns: Rectangular patterns (30-2, 30-2 bs, 24-2, 24-2 bs, 10-2),
Physiological patterns (Area 1-8), Quick Screening, Esterman, customized patterns
Stimulus sizes:/td> Goldmann I, III, V
Stimulus colour: White / Blue / Red
Stimulus luminance range / steps: 0 – 318 cd/m² (0 – 1 000 asb) / 0.1 log units
Background luminance: 10 cd/m² (31.4 asb)
Background colour: White / Yellow
Stimulus duration: 200 ms / User-defined
Examination speed: Adaptive / Slow / Normal / Fast / User-defined
Maximum eccentricity: 90° (full field)
Fixation control: Video camera image, through central threshold, Heijl-Krakau (using the blind spot)
Patient positioning: Motorised double chinrest, height- and depth-adjustable headrest, ergonomic armrest
Reports: Glaucoma Staging Program (GSP)
Threshold Noiseless Trend (TNT) progression report

Kinetic Perimetry

Strategies: Automatic isopters measured along meridians with freely selectable density
Manual: stimulus freely movable with the computer mouse
Semi-automatic: including scotoma boundary mapping
Stimulus speed: 2°/s (Goldmann), user-defined

Features

Bowl radius: r = 30 cm (11.8 in)
Dimensions (W x D x H): 790 x 723 x 850 mm (31.1 x 28.5 x 33.5 in)
Weight: 40.0 kg (88.1 lbs) – without table
Max. power consumption: 65 W – without table
Voltage: 90 – 264 V AC
Frequency: 50 – 60 Hz
Recommended computer specifications: Intel® Core i5, 3,4 GHz, 500 GB HD, Windows® 8
Interface: USB

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