Comparison of size modulation and conventional standard automated perimetry with the 24-2 test protocol in glaucoma patients

Hirasawa, Kazunori; Shoji, Nobuyuki; Kasahara, Masayuki; Matsumura, Kazuhiro; Shimizu, Kimiya

doi:10.1038/srep25563

Cited by 3 publications

(4 citation statements)

References 43 publications

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“…In early damage, several groups have reported that size modulation perimetry shows promise, because it may have a better signal-to-noise ratio than conventional perimetry (where size remains constant but contrast is modulated), in particular for detection of defects. 47 – 49 This finding is particularly true if stimuli are configured to remain smaller than Ricco's area of complete spatial summation, which expands in glaucoma. 49 However, RGC receptive fields exhibit a center-surround organization.…”

Section: Discussionmentioning

confidence: 99%

Moving Stimulus Perimetry: A New Functional Test for Glaucoma

Gardiner

Mansberger

2022

Trans. Vis. Sci. Tech.

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Purpose Static pointwise perimetric sensitivities of less than approximately 19 dB are unreliable in glaucoma owing to excessive variability. We propose using moving stimuli to increase detectability, decrease variability, and hence increase this dynamic range. Methods A moving stimulus was designed to travel parallel to the average nerve fiber bundle orientation at each location, and compared against an otherwise identical static stimulus. To assess dynamic range, psychometric functions were measured at 4 locations of each of 10 subjects. To assess clinically realistic test–retest variability, 34 locations of 94 subjects with glaucoma and glaucoma suspects were tested twice, 6 months apart. Pointwise sensitivity estimates were compared using generalized estimating equation regression models. The test–retest limits of agreement for each stimulus were assessed, adjusted for within-eye clustering. Results Using static stimuli, 9 of the 40 psychometric functions had less than a 90% maximum response probability, suggesting being beyond the dynamic range. Eight of those locations had asymptotic maximum of more than 90% with moving stimuli. Sensitivities were higher for moving stimuli ( P < 0.001); the difference increased as sensitivity decreased ( P < 0.001). Test-retest limits of agreement were narrower for moving stimuli (−6.35 to +6.48 dB) than static stimuli (−12.7 to +7.81 dB). Sixty-two percent of subjects preferred using moving stimuli versus 19% who preferred static stimuli. Conclusions Using a moving stimulus increases perimetric sensitivities in regions of glaucomatous loss. This extends the effective dynamic range, allowing reliable testing later into the disease. Results are more repeatable, and the test is preferred by most subjects. Translational Relevance Moving stimuli allow reliable testing in patients with more severe glaucoma than currently possible.

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Section: Discussionmentioning

confidence: 99%

Moving Stimulus Perimetry: A New Functional Test for Glaucoma

Gardiner

Mansberger

2022

Trans. Vis. Sci. Tech.

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“…The size modulation formula has been described previously. 2 , 19 The perimeter uses the size modulation technique for SAP; thus, maintaining the spatial summation of the stimuli within a dynamic range of 0 to 35 dB. The background luminance and maximum stimulus intensity of the Octopus 600 perimeter are 31.4 and 417 apostilb, respectively.…”

Section: Methodsmentioning

confidence: 99%

“…Although the threshold strategy helps measure retinal sensitivity at each test point more accurately, it also requires greater time for measurement — 5 to 10 minutes with the Swedish Interactive Threshold Algorithm (SITA)-Standard and 3 to 5 minutes with the SITA-Fast, using the Humphrey Field Analyzer (HFA), 1 4 to 7 minutes with the Dynamic strategy, 2,3 and 2 to 4 minutes with the Tendency Oriented Perimetry strategy 4,5 using the Octopus perimeter.…”

Section: Introductionmentioning

confidence: 99%

“…Standard automated perimetry (SAP) generally is performed using a 30-2 (or 32) or 24-2 test program arranged in a 6° grid pattern and the G program following the course of the nerve fiber layer, using a threshold strategy to detect and monitor visual field (VF) defects. Although the threshold strategy helps measure retinal sensitivity at each test point more accurately, it also requires greater time for measurement — 5 to 10 minutes with the Swedish Interactive Threshold Algorithm (SITA)-Standard and 3 to 5 minutes with the SITA-Fast, using the Humphrey Field Analyzer (HFA), 1 4 to 7 minutes with the Dynamic strategy, 2 , 3 and 2 to 4 minutes with the Tendency Oriented Perimetry strategy 4 , 5 using the Octopus perimeter.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Ability and Repeatability of a New Supra-Threshold Glaucoma Screening Program in Standard Automated Perimetry

Takahashi

Hirasawa

Hoshina

et al. 2017

Trans. Vis. Sci. Tech.

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PurposeWe assess the diagnostic ability and repeatability of a new suprathreshold glaucoma screening test (GST) comprising 28 test points and a 1-of-3 sampling strategy at 95% of the normal limit for standard automated perimetry (SAP) in early to advanced glaucoma.MethodsThis prospective cross-sectional study included 96 eyes of patients with early, moderate, or advanced glaucoma and 37 eyes of normal controls. Participants were evaluated by the G-Dynamic threshold test once and the GST twice, in random order, using the Octopus 600 perimeter. The diagnostic ability of GST was assessed by comparison with the G-Dynamic threshold obtained by receiver operating characteristic analysis. Repeatability was assessed by κ statistics for agreement on glaucoma diagnosis and each test point.ResultsAlthough the G-Dynamic test exhibited significantly higher areas under the curve (AUC) than the GST1st (P = 0.009) in early glaucoma, there were no significant differences in any other AUCs between the two methods. The κ values for repeatability of glaucoma diagnosis and each test point were 0.747 to 1.0 and 0.537 to 1.0, respectively. The duration of the GST in the control and early glaucoma groups was less than a minute, while that in the moderate and advanced glaucoma groups was within 1.5 minutes.ConclusionThe diagnostic ability of the new suprathreshold GST for early to advanced glaucoma was high, with moderate to strong repeatability and short test duration.Translational RelevanceThere currently are no prominent suprathreshold screening strategies using SAP. The GST would be an effective clinical method for glaucoma screening.

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