A Comparison between the Pulsed Rising Amplitude Perimetry and the Normal Staircase Strategy in Standard Automated Perimetry

Abstract

IntroductionStandard automated perimetry (SAP) is the currently accepted gold standard for detection and monitoring of glaucomatous dysfunction [1]. The outcome of SAP as a psychophysical test, however, is subjective and variable [2,3]. In the normal strategy (NS) the stimulus luminance varies stepwise, in order to define thresholds. As published literature clearly demonstrates, in cases with advanced visual field disturbances, increasing the accuracy of the estimated threshold and its reproducibility require prolongation of the examination time. This, in consequence, results in increasing fatigue-related artefacts [2,3], which hinder a direct comparison of local threshold resolution.New fast perimetric strategies, like Dynamic, Swedish Interactive Threshold Algorithm (SITA) and Tendency-Oriented Perimetry (TOP) aim at achieving a comparable high sensitivity and specificity for detection of disease and progression analysis, while taking considerably less time. Here, the examination time is decreased using the prior information about age-corrected normal thresholds values, frequency-of-seeing curves (FOS-curves) and correlations between different points, while the results of the already tested neighbouring points are taken into account, as well [4][5][6][7][8][9]. The significant gain in time in the TOP strategy, however, is producing a reduction in spatial resolution, making the test unsuitable for application in pathologies with very narrow, deep defects [8,9].One further attempt in optimising the test duration, while keeping an accurate threshold determination, is the introduction of methods based on continuous luminance variation. The rising amplitude perimetry (RAMP) and its modification -the continuous light increment strategy (CLIP) [10,11], in contrast to the TOP strategy, is assessing every single test location independently. Here, the slow temporal onset algorithm starts from invisible (subthreshold) light and increases in luminance until the patient responds to the light.In general, the determination of thresholds varies complexly and is dependent on several variables, including the effect of temporal summation, stimulus duration, speed of the light onset and wavelength of monochromatic light [12,13].For CLIP methods, the summative phenomenon of the neighboring areas after exposure to light, that is the effect of temporal summation, AbstractBackground and scope: Pulsed rising amplitude perimetry (pulsed RAMP) is an improved strategy for automated static perimetry, developed to save examination time without accuracy loss. The aim of this study was to identify characteristic differences between the normal strategy (NS) and the pulsed RAMP strategy in standard automated perimetry, in order to evaluate the potential of the pulsed RAMP for threshold estimation.

Metabolic, structural and functional alterations in patients with inherited diseases of the retina

“…; Todorova et al. ), with much attention on a higher deviation, as the disease progresses. Therefore, we aimed first to compare the test‐retest reliability of RO in a group of controls, as well as in diseased retinas assembled altogether in three test groups: controls, glaucoma patients and patients with inherited diseases of the retina.…”

“…Additional factor, which has been proven to improve the contrast between the retinal blood vessels and the retinal background in acquisition of digital retinal blood vessels images, is the 3-channel luminance histogram tool (Salem & Nandi 2006;Hubbard 2009), we applied in our study, as well. Results' variability has been discussed in some psychophysical and functional tests (Bock et al 1998(Bock et al -1999Seiple et al 2004;Todorova et al 2013), with much attention on a higher deviation, as the disease progresses. Therefore, we aimed first to compare the test-retest reliability of RO in a group of controls, as well as in diseased retinas assembled altogether in three test groups: controls, glaucoma patients and patients with inherited diseases of the retina.…”

Reproducibility of retinal oximetry measurements in healthy and diseased retinas

“…; Todorova et al. ), with much attention on a higher deviation, as the disease progresses. To date, only a few studies on RO reliability in healthy subjects have appeared in the literature (Blondal et al.…”

Improvement in Visual Function in Patients with Inherited Diseases of the Retina Following Acupuncture Treatment

“…The acupuncture protocol was developed for a group of retinal diseases, based on the extensive clinical experience of an ophthalmologist and a licensed, qualified and well-trained acupuncturist (BT). Resultsʼ subjectivity and variability has been discussed in some psychophysical and functional tests [28][29][30], with much attention on a higher deviation, as the disease progresses. A placebo control acupuncture group was not included in this pilot study, as the treatment remains controversial.…”