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PubMed1993

Longitudinal comparison of temporal-modulation perimetry with white-on-white and blue-on-yellow perimetry in ocular hypertension and early glaucoma.

We obtained data over 3 years on temporal-modulation perimetry (TMP), standard automated [white-on-white (W/W)] perimetry, and short-wavelength-sensitive [blue-on-yellow (B/Y)] perimetry in ocular hypertensive (OH) patients and patients with early glaucomatous visual-field loss (EG). Evidence of visual-field defects was obtained with the use of both B/Y perimetry and TMP in the majority of OH and EG eyes that demonstrated progression on W/W perimetry as well as in all stable EG eyes. Using the nerve-fiber-bundle pattern to compare testing procedures, we determined that these defects were generally as extensive or more extensive than the concurrent W/W abnormalities. In terms of location over the 3 years of testing, TMP and B/Y defects were reasonably consistent in the EG eyes, somewhat less consistent in the OH eyes demonstrating progression, and both inconsistent and infrequent in the stable OH eyes. The greatest degree of overlap occurred between the location of defects obtained by use of the higher TMP frequencies (8 and 16 Hz) and that of defects obtained by use of B/Y perimetry. Since these two methods are thought to isolate different visual mechanisms subserved by different visual pathways, these results suggest that early glaucomatous visual-field damage as revealed by TMP and B/Y perimetry may not be specific to a single visual pathway.

Color Perception Tests↗
PubMed2005

Relationship of SITA and full-threshold standard perimetry to frequency-doubling technology perimetry in glaucoma.

PURPOSE: To compare full-threshold (FT) and SITA algorithms for standard automated perimetry (SAP) with frequency-doubling technology perimetry (FDT) in glaucoma, to help clinicians to relate results in patients who have had two or more of these tests during follow-up. METHODS: This study was a retrospective analysis of data from a longitudinal prospective study at the University of California, San Diego. One hundred four eyes of 104 patients with glaucomatous optic neuropathy detected by optic disc stereophotographs were included. All patients had standard perimetry (SITA and FT) and FDT within 3 months of each other. Global indices, abnormality and severity using two threshold algorithms of standard perimetry were compared with FDT. RESULTS: More eyes had normal visual fields by SAP-FT (57 eyes) than by either SAP-SITA (42 eyes) or FDT (45 eyes), although SAP-FT agreed more closely with FDT (kappa = 0.54 +/- 0.08) on the presence of a visual field defect than did SAP-SITA (kappa = 0.34 +/- 0.08). Correlations of FDT to standard perimetry global indices were similar regardless of the threshold strategy used for standard perimetry, yielding r2= 0.38-0.57 for SAP-FT with FDT, 0.36-0.54 for SAP-SITA with FDT. CONCLUSIONS: Despite many similarities of SAP-SITA and SAP-FT, switching the standard of comparison from SAP-FT to SAP-SITA changes the relationship to FDT with regard to visual field abnormality, but not correlations of global indices. FDT detected abnormal fields in more eyes than SAP-FT. SAP-FT tended to detect a subset of eyes found abnormal by FDT. Visual field defects may be detected more often by FDT and SAP-SITA in eyes with early visual field loss, but these two tests may not agree on which eyes show field loss in patients who undergo both tests at follow-up.

Algorithms↗
PubMed1999

Comparison of threshold visual perimetry and objective pupil perimetry in clinical patients.

OBJECTIVES: In an attempt to measure the visual field objectively, we have performed pupil perimetry, by which the pupil light reflex is monitored in response to perimetric light stimuli. The purpose of this study was to ascertain whether pupil perimetry reveals defects similar to those revealed by standard threshold perimetry in patients with various diseases. MATERIAL AND METHODS: An infrared pupillometer was linked to an automated perimeter to record, at each perimetric location, 76 pupil contractions, which were comparable to the test locations of the Humphrey Field Analyzer (HFA 30-2 program; Humphrey, San Leandro, CA). One hundred eighteen patients with various diseases were investigated. RESULTS: Ninety-one patients (77.1%) maintained a pupil area large enough (more than 10 mm2 in area) to respond adequately to focal light stimuli throughout the test. The correlation between the pupil field and the threshold visual field was subjectively judged to be good in most cases. However, pupil perimetry showed less damage than that seen in threshold perimetry in six of nine patients who had Leber's hereditary optic neuropathy (LHON). CONCLUSIONS: Pupil perimetry is a good method for measuring the visual field objectively and has potential for clinical use in most of the cases.

Adult↗
PubMed2006

Automated combined kinetic and static perimetry: an alternative to standard perimetry in patients with neuro-ophthalmic disease and glaucoma.

OBJECTIVES: To create a fully automated, combined perimetry program consisting of a static examination and a kinetic examination, and to compare the results of this test with standard static and kinetic visual fields (VFs). METHODS: Fifty-six patients (74 eyes) undergoing neuro-ophthalmic or glaucoma evaluation who had standard static or kinetic perimetry examinations underwent the combined perimetry test. This automated, combined test, performed on the Octopus 101 perimeter, consisted of a static tendency-oriented perimetry examination and a preprogrammed kinetic examination. Three masked physician reviewers independently classified all of the VFs. The VF pairs were considered a match if the consensus descriptions of the standard and combined VFs matched. RESULTS: Thirty-seven eyes underwent evaluation for neuro-ophthalmic disease (comparison standard test, 20 static and 17 kinetic) and 37 for glaucoma (comparison standard test, 17 static and 20 kinetic). The VP pairs matched in 32 eyes (86%) in the neuro-ophthalmic group and 28 (76%) in the glaucoma group. On inspection by a fourth reviewer, many of the nonmatching VF pairs were those for which a consensus was not reached, but still conveyed similar information. Two glaucomatous eyes demonstrated central scotomata not delineated by the combined examination findings. Two subtle nasal steps were detected solely by the combined examination. The combined test ranged in time from 6 to 12 minutes per eye. CONCLUSIONS: The Octopus 101 perimeter can be used to create an automated test that combines the advantages of static and kinetic perimetry and produces equivalent results while not requiring examiner expertise.

Adolescent↗
PubMed2005

Comparison between semiautomated kinetic perimetry and conventional Goldmann manual kinetic perimetry in advanced visual field loss.

PURPOSE: To compare quantitatively visual field (VF) results obtained using a new standardized semiautomated kinetic perimetry (SKP) with those obtained by conventional Goldmann manual kinetic perimetry (MKP) in patients with advanced VF loss. DESIGN: Prospective, single-center, observational comparative case series. SUBJECTS AND METHODS: Seventy-seven eligible patients (36 suffering from advanced retinal nerve fiber layer loss, 20 with concentric constriction of the VF, and 21 with hemianopia) were included in the study. One eye of each patient was examined on the same day with MKP and SKP. Three isopters, identical in both tests, were chosen to assess the extent of the VF loss. To compare the location and size of the corresponding isopters obtained with MKP and SKP, intersection areas of superimposed isopters were expressed as a percentage of union areas. MAIN OUTCOME MEASURES: The area and position of isopters for a defined stimulus condition obtained with both methods were compared. Test duration and patients' preference were also evaluated. RESULTS: Isopters obtained with Goldmann MKP enclosed areas smaller by 20% (confidence interval [CI], 12%-27%). The mean intersection area of Goldmann and SKP VFs was 1763.1 square degrees (CI, 1558.6-1967.7) smaller than the union for stimulus III4e over all groups of patients. Semiautomated kinetic perimetry was preferred by 60% of patients with concentric constriction of the VF. Median duration of the examination was 15 minutes and did not differ significantly between the 2 methods. CONCLUSIONS: Our results indicate that SKP isopter shape and size were very comparable to those obtained on the same eyes with MKP. Semiautomated kinetic perimetry may represent a more standardized method of kinetic perimetry, which still takes advantage of perimetrist-patient interaction to diagnose and monitor advanced VF loss in clinical practice.

Adolescent↗
PubMed2002

Short wavelength automated perimetry, frequency doubling technology perimetry, and pattern electroretinography for prediction of progressive glaucomatous standard visual field defects.

PURPOSE: To evaluate the clinical use of a test battery of short wavelength automated perimetry (SWAP), frequency doubling technology perimetry (FDT), and pattern electroretinography (PERG) in predicting progressive glaucomatous visual field defects on standard automated perimetry (SAP). STUDY DESIGN: A prospective, longitudinal, observational case series. PARTICIPANTS: One hundred and fifty-two patients with primary open-angle glaucoma (POAG) with bilateral glaucomatous visual field defects on SAP were followed at 6-month intervals over a period of 30 months. MAIN OUTCOME MEASURES: Short wavelength automated perimetry, FDT, and PERG results were compared between POAG eyes with and without progressive field loss on SAP. These two groups were used to evaluate whether PERG, SWAP, and/or FDT is predictive of future progression of field loss on SAP. RESULTS: Using the criteria of progressive field loss on SAP defined by the Collaborative Normal Tension Glaucoma Study, 54 eyes (study group) of 54 POAG patients showed progressive defects, whereas 84 eyes (control group) of 84 POAG patients showed no progression. Only 11.1% (6 of 54) of the eyes with a progression of field loss on SAP showed no increase of deficits on the three functional tests before progression. Short wavelength automated perimetry detected early progressive defects on SAP in 43 of the 54 eyes (79.6%). Of these 54 POAG eyes, FDT showed progressive deficits in 40 eyes (74.1%), whereas PERG amplitude P1N2 showed progressive deficits in 35 eyes (64.8%) before progression of field loss on SAP. A test battery consisting of SWAP and PERG P1N2-amplitude was able to detect 88.9% of eyes before a prediction of field loss on SAP. When comparing the results of the two functional tests, SWAP and FDT in the 84 eyes without progression of field loss on SAP between baseline and at 30 months, SWAP and FDT showed progressive deficits in 34.5% and 35.7%, respectively. CONCLUSIONS: All three tests (SWAP, FDT, and PERG) have been successful in detecting glaucoma eyes with a future progression of standard visual field defects. A test battery of SWAP and PERG P1N2-amplitude improved the power to predict these progressive defects on SAP. It remains to be seen whether the long-term follow-up in POAG eyes will improve the false-positive rate of SWAP and FDT.

Disease Progression↗
PubMed2006

Multifocal objective perimetry compared with Humphrey full-threshold perimetry in patients with optic neuritis.

BACKGROUND: The aim of the study is to compare multifocal visual evoked potential (mfVEP) objective perimetry with Humphrey full-threshold visual field (HVF) perimetry, in the assessment of patients with optic neuritis (ON). METHODS: We assessed 16 patients with clinically diagnosed ON. A comparison was made between the HVF and mfVEP, based on the global severity indices of both tests and number and topography of significant abnormalities detected. The latency data and inter-eye asymmetry findings on the mfVEP were also evaluated. RESULTS: From a total of 128 quadrants analysed in the 16 patients (100 affected, 28 unaffected eyes), HVF perimetry identified a scotoma in 39/128 (30.5%) quadrants, all of which were in affected eyes; the mfVEP detected a scotoma in 68/128 (53.1%) quadrants using amplitude and/or asymmetry data (XV2=7.2485, P=0.0071). Latency plots on the mfVEP identified a significant latency deviation cluster in 20/25 (80%) affected eyes. Abnormalities were also detected in 4/7 (57%) unaffected eyes. The global severity indices in the affected eyes showed a high correlation between the two tests (r=0.73). CONCLUSIONS: The mfVEP detected more abnormalities in patients with ON than HVF perimetry. The use of latency recordings as well as combined amplitude and asymmetry plots is advantageous and has the potential to detect abnormalities not otherwise detected on HVF perimetry.

Adolescent↗
PubMed2005

Feasibility and outcome of automated static perimetry in children using continuous light increment perimetry (CLIP) and fast threshold strategy.

PURPOSE: Visual field testing in children is always a challenge as testing is hampered by fatigue effects, easy distraction and lack of comprehension. For that reason new testing strategies for automated perimetry have mainly been evaluated on adults. We tested the feasibility and outcome of automated static perimetry in children in a standard clinical setting. METHODS: Twenty-eight children aged 5-14 years were examined at the Twinfield perimeter, including healthy children, children with unilateral pathologies (normal eye tested) and children with strabismus. Fast threshold strategy (FT) and continuous light increment perimetry (CLIP) strategy were used in a randomized order. One eye per subject was examined and each test was performed twice. RESULTS: Reliable results were obtained in many children starting from the age of 8 years. In children aged 13 years and over, adult testing strategies were possible in most cases with good reproducibility. No significant difference was found between the children with strabismus and the other children. Mean sensitivity (MS) increased and fixation losses decreased as a function of age. Continuous light increment perimetry showed a lower number of abnormal fields and fewer false-positive errors compared to FT. CONCLUSION: Automated static perimetry is possible in many children in a clinical setting using a commercially available Twinfield perimeter in a session of clinically practical duration. Test performance was not only dependent on age, but also on the child's maturity and ability to concentrate. Especially in children up to the age of 8 years, testing with the ramp stimulus (CLIP) was easier than with a staircase strategy (FT).

Adolescent↗
PubMed2006

Topography of the frequency doubling perimetry visual field compared with that of short wavelength and achromatic automated perimetry visual fields.

BACKGROUND: Traquair described the topography of visual field sensitivity as a "hill" or "island" of vision. Achromatic automated perimetry (AAP) demonstrates this shape of the visual field in photopic conditions. Techniques claimed to target the magnocellular pathway (frequency doubling perimetry, FDP) and those using a stimulus targeting the koniocellular pathway (short wavelength (or blue on yellow) automated perimetry, SWAP), might produce one that is different. The authors compared the visual field topography from FDP with those of SWAP and AAP, to investigate whether there were significant differences in their shape. METHOD: A sample of 51 patients with previously confirmed normal perimetry were recruited; either low risk glaucoma suspects or normal controls. AAP, SWAP, and FDP perimetry was performed in random order on the same day. The topography of each field was analysed to determine its average shape and to compare results in the same individuals. RESULTS: The topography of the visual field produced by each perimeter differed significantly. While all three had maximal sensitivity centrally, over the 24 degrees from the centre to the periphery, mean sensitivities decreased by 4.9 decibels (dB) for AAP and 7.3 dB for SWAP, while FDP sensitivities by just 1.8 dB over 20 degrees (the extent of the FDP field). FDP mean sensitivities decreased by approximately 0.3 dB with every 10 year increase in age, compared with 1 dB for AAP and 2 dB for SWAP. CONCLUSION: While the topography of the SWAP (koniocellular) field is steeper than corresponding AAP fields, that of the FDP (magnocellular) visual field was considerably flatter. The difference in this shape may reflect retinotopic or cortical mechanisms, which are specific to the magnocellular pathways.

Adult↗
PubMed2001

Comparison of pupil perimetry and visual perimetry in normal eyes: decibel sensitivity and variability.

PURPOSE: To compare the sensitivity and variability of pupil perimetry with visual perimetry at the same retinal locations in normal subjects. METHODS: Pupil perimetry was performed on the right and left eyes of 10 normal subjects using a computerized infrared pupillometer equipped to present perimetric light stimuli and record pupil light reflexes. Eleven locations were tested at different intensities along the horizontal meridian of each eye, and the decibel sensitivity of the pupil light reflex was compared with the visual threshold at the same location. RESULTS: The shape and height of the hill of vision (retinal sensitivity) was very similar between the right and left eyes of each individual using either pupil perimetry (R2 = 0.69) or standard threshold perimetry (R2 = 0.62) but was less similar between subjects. Comparisons between pupil and visual sensitivity revealed a lack of correlation at the same retinal location in normal eyes (R2 = 0.19). CONCLUSIONS: The high intereye correlation for either pupil or visual sensitivity may provide an important tool for detecting focal or asymmetric visual field damage. Although the basic shape of the sensitivity profile of pupil and visual responses was similar under the conditions of testing, the two did not correlate well within each eye among the normal subjects. This highlights that similarities do exist in the sensitivity profile of the two pathways, but they do not seem to vary in the same proportion between normal individuals.

Adult↗
PubMed1989

[The significance of static quantitative threshold perimetry and the barring of blind spot in kinetic quantitative perimetry in chronic open angle glaucoma].

The staircase threshold perimetry was measured for the 180 degrees-0 degree, 15 degrees, 165 degrees, 195 degrees and 345 degrees meridians of normal subjects and COAG patients. The kinetic quantitative perimetry was also tested in normal subjects with the I1e, I 2 e, I 3 e and I 4 e targets. The results were as follows: (1) The threshold for the 180 degrees-0 degree meridian at 20 degrees in the nasal side was lower than at 20 degrees in the temporal side in normal subjects (P less than 0.001); (2) the physiological blind spot in static threshold perimetry was 5.4 degrees +/- 0.942 degree in normal subjects and 8.09 degrees +/- 1.126 degree in COAG respectively on the horizontal meridian (P less than 0.001); (3) the nasal visual field defects in static threshold perimetry of COAG progressed from the periphery inward; (4) the upper nasal 15 degrees and 165 degrees meridian were more vulnerable than the lower nasal 195 degrees and 345 degrees meridians in COAG patients; (5) the thresholds of 15 degrees, 165 degrees, 195 degrees and 345 degrees meridians in COAG were much higher than those in normal subjects (P less than 0.001); and (6) in kinetic quantitative perimetry, the pseudobaring of physiological blind spot could be detected using the I1e target, with higher frequency in normal subjects over 40 years of age than under 40 years of age (P less than 0.005). The causes of differences in the visual field threshold, the nasal visual field defects, and pseudobaring of physiological blind spot were discussed, with evaluation of their diagnostic significance for COAG.

Adult↗
PubMed1994

[Effect of artificial media opacities on Frisén ring perimetry and conventional light sense perimetry. A comparative study].

In this study we compare the influence of blurring by diffusor foils (Bangerter) on visual acuity and on the thresholds of ring and light sense perimetry. Light sense perimetry was performed using the G1 program of the Octopus 1-2-3 perimeter [1], and ring perimetry with the "ring" test, version 2.20 (High-Tech-Vision) designed by Frisén [4]. Ten eyes of ten healthy persons with a visual acuity of 1.25 or better were examined at six different levels corresponding to visual acuities between 1.6 and hand movements. With both perimeters sensitivity decreased with decreasing visual acuity. At good visual acuities (1.2-1.6) no changes were found in either ring perimetry or light sense perimetry. At acuity levels of 0.8 and below a more pronounced decrease in sensitivity was found with the ring perimeter than with the light sense perimeter. At the level of hand movements there were only absolute scotomas in the ring perimeter, while the Octopus 1-2-3 still detected a baseline sensitivity. Sensitivity was correlated with the logarithm of the visual acuity with both perimeters (Octopus 1-2-3: r = 0.99, P < 0.001; ring perimeter: r = 0.98, P < 0.001). The decrease in sensitivity per log-unit of visual acuity was 9.43 dB (Octopus 1-2-3) or 5.19 dB (ring perimeter). The ring perimeter, at least in its currently available version giving an absolute scotoma at mean scores > 14 dB, is obviously more sensitive to media opacities than the Octopus 1-2-3. This may be of importance in the clinical evaluation of the test results.

Adult↗
PubMed1998

[Threshold-oriented suprathreshold perimetry and threshold value perimetry with the Tübigen CC Automated Perimeter. A comparative study].

BACKGROUND: We compared the standard suprathreshold strategy to the so-called threshold splitting strategy with 5 and 2 dB steps. The aim of the study was to establish whether the threshold splitting strategy had advantages over the suprathreshold strategy that has been used to date. METHOD: We examined the 30 degrees visual field in 49 volunteers using suprathreshold perimetry and on the same day threshold splitting perimetry on the Tübinger Automatic Perimeter CC. A total of 191 test points were examined in suprathreshold strategy. Using the threshold splitting strategy, 67 test points were examined, with a test-point design similar to other perimeters with the threshold splitting strategy. The criteria for inclusion in the study were central light sensitivity differences greater than 25 dB, fixation better than 80% and an illumination class density < 2. RESULTS/DISCUSSION: The average duration of the examination using the suprathreshold strategy was 2-3 min quicker than the threshold splitting strategy in normal visual fields or small scotomas, but it took up to 15 min longer if large scotomas were presents. Interpretation of the scotoma configuration showed subjective differences: the smaller the scotoma, the greater the differences because of the fact that threshold splitting perimetry utilizes test points that are farther apart than those used in suprathreshold perimetry.

Adolescent↗
PubMed2006

Comparison of visual field defects using matrix perimetry and standard achromatic perimetry.

PURPOSE: To compare visual field (VF) defects found by Swedish interactive thresholding Algorithm (SITA) perimetry and Matrix perimetry, a new VF device that utilizes frequency doubling technology in a 24-2 test pattern. DESIGN: Prospective cross-sectional study. PARTICIPANTS: Fifty eyes from 50 subjects with SITA field defects were recruited for an observational study. METHODS: Swedish Interactive Threshold Algorithm and Matrix VF testing were performed on patients from a glaucoma practice. To evaluate the learning effect on the performance of the VF, we tested subsets of each group who had previous experience with standard automated perimetry (SAP). MAIN OUTCOME MEASURES: Test duration, mean threshold, mean deviation (MD), pattern standard deviation (PSD), glaucoma hemifield test, and number of abnormal points on the pattern deviation plot were evaluated for each device. RESULTS: Test duration was significantly shorter for Matrix (SITA, 357.0+/-85.6 seconds; Matrix, 319.5+/-16.5 seconds; P = 0.0002, paired t-test). Thirty-six percent of eyes with SITA VF defects showed a normal Matrix field. In 30 of 32 eyes (94%) where both devices showed VF defects, the defects were congruent. Mean threshold value was significantly lower with Matrix compared to SITA (P<0.0001, paired t-test), as was MD (-5.34+/-5.42 dB, -4.14+/-5.29 dB, respectively; P = 0.03, paired t-test). There was no significant difference in PSD between the 2 devices (P = 0.78, paired t-test). Matrix delineated significantly smaller (P = 0.005, Wilcoxon's test) and deeper (P<0.001, Wilcoxon's test) defects than those found with SITA. Similar results were observed in the subgroups with prior SAP experience. CONCLUSIONS: The Matrix examination did not detect 36% of abnormal SITA fields. Matrix field defects were smaller and deeper than those appearing in SITA perimetry.

Adult↗
PubMed2003

Blue-on-yellow perimetry versus achromatic perimetry in type 1 diabetes patients without retinopathy.

In this study, we compared the blue-on-yellow perimetric parameters with conventional automated static threshold perimetric parameters in the detection of psychophysical abnormality in patients with type 1 diabetes mellitus (DM) without diabetic retinopathy. Forty-three patients with type 1 DM without diabetic retinopathy were included this study. Thirty subjects served as age-matched control group. Blue-on yellow perimetry was performed and the results compared to white-on-white perimetry. The values of mean deviation by blue-on-yellow perimetry in the diabetic group were significantly higher than in the control group (P=0.0001). The indices of short fluctuation, pattern standard deviation, corrected pattern standard deviation and foveal sensitivity which all relate to localized depression in sensitivity were similar in both groups. The achromatic perimetric parameters were not different between the groups. We conclude that the short-wavelength-sensitive cones are vulnerable to damage from hyperglycemia and this influence can be detected early by blue-on-yellow perimetry in diabetic patients without retinopathy.

Adolescent↗
PubMed2006

Short wavelength-automated perimetry compared with standard achromatic perimetry in autosomal dominant optic atrophy.

BACKGROUND: Autosomal dominant optic atrophy (ADOA, Kjer-type) is a heterogeneous, non-inflammatory degeneration of retinal ganglion cells. The diagnosis of ADOA can be challenging owing to its insidious onset and large variability in phenotypic expression, both within and between individual pedigrees. The earliest literature reports relatively mild centrocaecal scatomas to white targets in ADOA, but extensive and dense peripheral field loss to coloured targets, especially blue, with Bjerrum perimetry. The phrase "inverted peripheral visual fields to coloured targets" has been used to describe this phenomenon. METHODS: Humphrey standard achromatic perimetry (SAP) and short wavelength-automated perimetry (SWAP) were carried out on five patients with ADOA. RESULTS: Regardless of wide variations in patient age, visual acuity, disc appearance and colour vision, the SWAP mean deviation (MD) was between 10 and 20 times more depressed than the SAP MD. The actual differences ranged from 9.38 to 13.78 dB. CONCLUSIONS: These data are consistent with the original reports suggesting that, early in this disease process, the blue-target deficits are typically peripheral and that this difference between SAP and SWAP perimetry may be a robust indicator of ADOA in both early and late stages of this disease.

Adolescent↗
PubMed2002

Use of high spatial resolution perimetry to identify scotomata not apparent with conventional perimetry in the nasal field of glaucomatous subjects.

AIM: To examine whether high spatial resolution perimetry (HSRP) could identify fine scale scotomata which may not be apparent with conventional perimetry. The HSRP was performed in the nasal field, as this location is a recognised site for the early occurrence of glaucomatous defects. METHOD: 16 early glaucoma eyes, 17 glaucoma suspect eyes, and 20 age matched healthy control eyes underwent conventional automated perimetry using the 24-2 program of the Humphrey field analyser (HFA) and HSRP. The HSRP was performed in the nasal field by testing 9 x 9 degrees of 100 tested points separated by 1 degree and the results compared with the HFA 24-2 program. RESULTS: Mean HSRP thresholds were significantly abnormal in the suspect and glaucoma eyes, with elevated levels of asymmetry between the superior and inferior nasal field. Overall, 7/17 (41%) suspect eyes (95% confidence interval 5/17 (29%) to 7/17 (41%)) had nasal scotomata on HSRP, although their HFA 24-2 fields failed to identify any defects. In glaucomatous eyes, 15/16 (94%) eyes had HSRP scotomata (95% CI 14/16 (88%) to 15/16 (94%)). In 12 these coexisted with HFA 24-2 defects at the same location, while in three eyes only HSRP identified scotomata in the nasal field. CONCLUSION: HSRP can identify scotoma in glaucomatous eyes in the nasal field which may be missed with the lower spatial resolution of conventional perimetry.

Aged↗