Multicenter Evaluation of Tendency-Oriented Perimetry (TOP) Using the G1 Grid

Abstract

Purpose The G1-TOP program is a short automated perimetric strategy which sub-divides the G1 grid of 59 points into four sub-grids. Each point is tested only once, but each patient's response is used to modify that particular point and the surrounding ones from the remaining sub-grids. This study compared the results of the G1-TOP program with the Standard Bracketing strategy. Methods Eleven participating institutions provided data from 213 patients (406 eyes). The main group consisted of 284 glaucomas and 55 glaucoma suspects. Other groups included 31 eyes with neurological disorders, 20 with chorioretinal lesions and 16 normal eyes. Mean age was 62.7 ± 15.4 (range 14–88) years. All subjects had previous perimetric experience and visual acuity better than 0.5. Examination included G1-Standard Bracketing and G1-TOP testing, in interchangeable order, with the Octopus 1-2-3 perimeter. Results The correlation coefficient for mean defect (MD) was 0.95. Standard error (YX) for MD, square root of loss variance (LV) and individual thresholds were 1.86 dB, 1.29 dB, and 4.72 dB, respectively. Mean sensitivity values were similar (difference 0.04 ± 1.87 dB) (p>0.05). Mean duration for G1-TOP was 2.19 ± 0.26 min, while G1-Standard Bracketing took 11.51 ± 1.52 min (ratio 1/5.1, or a net reduction of 80.4%). The sensitivity of G1-TOP versus G1-Standard Bracketing was: glaucoma 77.1/78.5, glaucoma suspects 38.2/47.3, neurological disorders 87.1/87.1 and chorioretinal lesions 80.0/85.0. Conclusions The G1-TOP program gave very similar results to G1-Standard Bracketing in only 20% of the time required by the standard strategy.

Specificity of the Program Threshold Noiseless Trend for Perimetric Progression Analysis

“…17,18 We detected progression in 204 eyes using TNT. Mean age of the sample was 64.1 years (sd = 20.6) and mean number of examinations was 11.1 (sd = 4.2).…”

Diagnostic Accuracy and Reproducibility of Tendency Oriented Perimetry in Glaucoma

“…Several studies have documented equivalent diagnostic capabilities between TOP and standard FT strategies (4)(5)(6)(7)(8). Better test-retest reproducibility may be achieved with TOP (9).…”

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

“…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.…”

“…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.…”