Increased detection rate of glaucomatous visual field damage with locally condensed grids: a comparison between fundus-oriented perimetry and conventional visual field examination.

OBJECTIVE To compare detection rates of glaucomatous visual field defects (VFDs) between the conventional 6 degrees x 6 degrees stimulus grid and locally condensed target arrangements in morphologically suspicious regions. METHODS A total of 66 eyes of 66 patients with glaucoma or patients suspected of having glaucoma (34 females and 32 males; age range, 14-85 years) were enrolled in this study. Individual, local target condensation was realized by fundus-oriented perimetry (FOP) using a campimeter and compared with the results of conventional automated perimetry (CAP), obtained with the Humphrey Field Analyzer (30-2 grid). RESULTS Twenty-three of the 66 patients showed normal findings with both methods; 27 had concordantly pathological results. In 15 patients we obtained normal findings with CAP, whereas FOP revealed early glaucomatous VFDs. Only one patient showed VFDs with CAP, whereas FOP results were normal. Scotoma detection rates significantly differed between the 2 methods (P<.001, sign test). Test duration with FOP was more than doubled compared with CAP. When considering only FOP points coinciding with the 6 degrees spacing of the 30-2 grid, there was no longer a significant difference between FOP and CAP (P>.25, sign test). This indicated that the target pattern, rather than the perimetric device, was most relevant for detecting glaucomatous VFDs. Follow-up throughout a series of 3 subsequent sessions at 6-month intervals revealed repeatable results in more than two thirds of all eyes for both FOP and CAP. CONCLUSIONS Fundus-oriented perimetry that uses individually condensed test grids significantly increases the detection rate of glaucomatous VFDs in morphologically conspicuous areas compared with CAP using equidistant (6 degrees x 6 degrees) target arrangements. Repeatability is comparable between both methods.

[1]  P. Lichter,et al.  The Collaborative Initial Glaucoma Treatment Study: study design, methods, and baseline characteristics of enrolled patients. , 1999, Ophthalmology.

[2]  David P Crabb,et al.  High spatial resolution automated perimetry in glaucoma , 1997, The British journal of ophthalmology.

[3]  Douglas Hoffman,et al.  Neural networks to identify glaucomatous visual field progression. , 2003, American journal of ophthalmology.

[4]  F. Casagrande,et al.  Differential expression of G1 cyclins and cyclin-dependent kinase inhibitors in normal and transformed melanocytes. , 1998, Investigative ophthalmology & visual science.

[5]  B. Selig,et al.  Angioscotoma detection with fundus-oriented perimetry A study with dark and bright stimuli of different sizes , 1999, Vision Research.

[6]  U. Schiefer,et al.  STATIC CAMPIMETRY WITH LOCALLY ENHANCED SPATIAL RESOLUTION , 1999 .

[7]  B. Bengtsson,et al.  Glaucoma follow-up when converting from long to short perimetric threshold tests. , 2000, Archives of ophthalmology.

[8]  Chris A Johnson,et al.  Classification of visual field abnormalities in the ocular hypertension treatment study. , 2000, Archives of ophthalmology.

[9]  A Heijl,et al.  SITA Fast, a new rapid perimetric threshold test. Description of methods and evaluation in patients with manifest and suspect glaucoma. , 1998, Acta ophthalmologica Scandinavica.

[10]  B. Wabbels,et al.  Automatische kinetische Perimetrie mit unterschiedlichen Prüfgeschwindigkeiten , 2001, Der Ophthalmologe.

[11]  Yasuo Ohta,et al.  Experimental Fundus Photo Perimeter and its Application , 1979 .

[12]  Hans Strasburger,et al.  Reaction time in automated kinetic perimetry: effects of stimulus luminance, eccentricity, and movement direction , 2001, Vision Research.

[13]  T. Berg,et al.  COMPARISON OF SITA AND DYNAMIC STRATEGIES WITH THE SAME EXAMINATION GRID , 1999 .

[14]  Chris A. Johnson,et al.  CONFIRMATION OF VISUAL FIELD ABNORMALITIES IN THE OCULAR HYPERTENSION TREATMENT STUDY (OHTS) , 1999 .

[15]  M. Schwartz,et al.  Self-destructive and self-protective processes in the damaged optic nerve: implications for glaucoma. , 2000, Investigative ophthalmology & visual science.

[16]  U. Schiefer,et al.  Models for the description of angioscotomas , 1999, Vision Research.

[17]  H. Rootzén,et al.  A new generation of algorithms for computerized threshold perimetry, SITA. , 2009, Acta ophthalmologica Scandinavica.

[18]  F Dannheim,et al.  The topographical relationship between optic disc and visual field in glaucoma , 1990, Acta ophthalmologica.

[19]  Advanced Glaucoma Intervention Study. 2. Visual field test scoring and reliability. , 1994, Ophthalmology.

[20]  P. Sample.  What does functional testing tell us about optic nerve damage? , 2001, Survey of ophthalmology.

[21]  U. Schiefer,et al.  Automated perimetry with bright and dark stimuli. , 1995, German journal of ophthalmology.

[22]  K Rohrschneider,et al.  Stability of fixation: results of fundus-controlled examination using the scanning laser ophthalmoscope. , 1995, German journal of ophthalmology.

[23]  J Katz,et al.  Comparison of analytic algorithms for detecting glaucomatous visual field loss. , 1991, Archives of ophthalmology.

[24]  J. Katz,et al.  Scoring systems for measuring progression of visual field loss in clinical trials of glaucoma treatment. , 1999, Ophthalmology.

[25]  A Heijl,et al.  Early Manifest Glaucoma Trial: design and baseline data. , 1999, Ophthalmology.

[26]  Michal Schwartz,et al.  Degeneration of Spared Axons Following Partial White Matter Lesion: Implications for Optic Nerve Neuropathies , 1998, Experimental Neurology.

[27]  M. Weitzman,et al.  Comparison between Tendency-Oriented Perimetry (TOP) and octopus threshold perimetry. , 2000, Ophthalmology.

[28]  Kazutaka Kani,et al.  Fundus Controlled Perimetry , 1979 .