Spatial Pattern of Glaucomatous Visual Field Loss Obtained with Regionally Condensed Stimulus Arrangements

Schiefer, Ulrich; Papageorgiou, Eleni; Sample, Pamela A.; Pascual, J.P.; Selig, Bettina; Krapp, E.; Paetzold, J.

doi:10.1167/iovs.09-5067

Cited by 116 publications

(118 citation statements)

References 43 publications

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“…Second, what about macular damage to the lower VF? Macular damage of the lower VF is typically less common, less severe, and usually further from fixation 9,13,15,16,18 as also predicted by the model. 17 Because this damage tends to be at the edge of the macula, it is more likely to be detected by the 24-2 test.…”

Section: Limitations and Future Directionssupporting

confidence: 66%

“…13,15,16,18 The typically employed VF test pattern, the 24-2, can underestimate and even miss these arcuate, upper VF defects. 5,13,18 The anatomical basis for this is now clear. The local RGC layer thinning associated with these upper VF defects falls largely within the centralmost four points of the 24-2 test.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15][16][17] While macular damage may have a relatively mild diffuse component, 6 of particular concern are the deep localized defects close to fixation, which occur largely in the upper VF. 5,[13][14][15]18 To better understand these defects, we 18 studied 11 eyes with arcuate-like defects on the 10-2 VF test, but without defects outside the central 108 on the 24-2 VF (68 grid) test. In 10 of 11 eyes, the defect was in the upper VF.…”

Section: Introductionmentioning

confidence: 99%

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A Test of a Model of Glaucomatous Damage of the Macula With High-Density Perimetry: Implications for the Locations of Visual Field Test Points

Hood¹,

Nguyen²,

Ehrlich³

et al. 2014

Trans. Vis. Sci. Tech.

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Purpose: To use high-density perimetry to test a model of local glaucomatous damage to the macula (central visual field [VF]) and to assess the optimal placement of stimuli used to detect this damage.Methods: Thirty-one eyes of 31 patients showing glaucomatous arcuate damage within the upper hemifield of the central 108 were tested with a customized VF with double the density of the 10-2 (28 grid) test. Individual plots of total deviation (TD) values were generated. A model, which predicts a ''vulnerable macular region'' (VMR) and a ''less vulnerable macular region'' (LVMR), was compared with the TD values without (standard model) and with (aligned model) scaling and rotating to align it with the patient's fovea-to-disc axis. Computer simulations assessed alternative VF locations for adding two points to the 68 grid pattern (e.g., 24-2 VF) typically used in the clinic.Results: There were significantly more abnormal points in the VMR than in the LVMR. However, the aligned model did no better than the standard model in describing the data. The optimal locations for adding two points to the 24-2 (68 grid) test were (À18, 58) and (18, 58), both within the VMR. Conclusions:The model describes the region of the superior VF vulnerable to arcuate damage.Translational Relevance: The model can be used to determine the optimal locations for adding test points to the commonly used VF test pattern (24-2). It does not seem necessary to adjust the location of VF test points based upon interindividual differences in the fovea-to-disc axis.

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Section: Limitations and Future Directionssupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Test of a Model of Glaucomatous Damage of the Macula With High-Density Perimetry: Implications for the Locations of Visual Field Test Points

Hood¹,

Nguyen²,

Ehrlich³

et al. 2014

Trans. Vis. Sci. Tech.

Self Cite

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“…These study points represent a superior arcuate defect and a nasal step, locations of very typical glaucomatous VF defects. [37][38][39] Paracentral points (19 and 10) have also been documented as very typical of glaucoma, especially when regionally enhanced spatial resolution is used, 40 but points close to the fovea did not present with good AUCs in our sample (mild glaucoma). We used non-equivalent strategies from both perimetry types, SITA Standard and TOP, because they are the default strategies used in clinical practice.…”

Section: Discussionmentioning

confidence: 75%

Diagnostic ability of Humphrey perimetry, Octopus perimetry, and optical coherence tomography for glaucomatous optic neuropathy

Monsalve

Ferreras

Calvo

et al. 2016

Eye

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Purpose To evaluate and compare the diagnostic accuracy of the Humphrey Field Analyzer (HFA), Octopus perimetry, and Cirrus OCT for glaucomatous optic neuropathy. Methods Eighty-eight healthy individuals and 150 open-angle glaucoma patients were consecutive and prospectively selected. Eligibility criteria for the glaucoma group were intraocular pressure ≥ 21 mm Hg and glaucomatous optic nerve head morphology. All subjects underwent a reliable standard automated perimetry with the HFA and Octopus perimeter, and were imaged with the Cirrus OCT. Receiver-operating characteristic (ROC) curves were plotted for the threshold values and main indices of the HFA and Octopus, the peripapillary retinal nerve fiber layer thicknesses, and the optic nerve head parameters. Sensitivities at 85 and 95% fixedspecificities were also calculated. The best areas under the ROC curves (AUCs) were compared using the DeLong method. Results In the glaucoma group, mean deviation (MD) was − 5.42 ± 4.6 dB for HFA and 3.90 ± 3.6 dB for Octopus. The MD of the HFA (0.966; Po0.001), mean sensitivity of the Octopus (0.941; Po0.001), and average cup-todisc (C/D) ratio measured by the Cirrus OCT (0.958; Po0.001) had the largest AUCs for each test studied. There were no significant differences among them. Sensitivities at 95% fixed-specificity were 82% for pattern standard deviation of the HFA, 81.3% for average C/D ratio of OCT, and 80% for the MD of the Octopus. Conclusions HFA, Octopus, and Cirrus OCT demonstrated similar diagnostic accuracies for glaucomatous optic neuropathy. Visual field and OCT provide supplementary information and thus these tests are not interchangeable.

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“…8 Other mathematical models have been developed to study the effects on the visual field of neurological disease, trauma, retinal degenerations, 9,10 and glaucoma. 11,12 Perimetry data can be condensed into global indices of visual function. These indices quantify and distill trends in the visual field into simple numerical summary measures, and are important as endpoints in therapeutic trials, longitudinal analyses, and patient assessments.…”

mentioning

confidence: 99%

VFMA: Topographic Analysis of Sensitivity Data From Full-Field Static Perimetry

Weleber

Smith

Peters

et al. 2015

Trans. Vis. Sci. Tech.

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Purpose: To analyze static visual field sensitivity with topographic models of the hill of vision (HOV), and to characterize several visual function indices derived from the HOV volume.Methods: A software application, Visual Field Modeling and Analysis (VFMA), was developed for static perimetry data visualization and analysis. Three-dimensional HOV models were generated for 16 healthy subjects and 82 retinitis pigmentosa patients. Volumetric visual function indices, which are measures of quantity and comparable regardless of perimeter test pattern, were investigated. Cross-validation, reliability, and cross-sectional analyses were performed to assess this methodology and compare the volumetric indices to conventional mean sensitivity and mean deviation. Floor effects were evaluated by computer simulation.Results: Cross-validation yielded an overall R 2 of 0.68 and index of agreement of 0.89, which were consistent among subject groups, indicating good accuracy. Volumetric and conventional indices were comparable in terms of test-retest variability and discriminability among subject groups. Simulated floor effects did not negatively impact the repeatability of any index, but large floor changes altered the discriminability for regional volumetric indices.Conclusions: VFMA is an effective tool for clinical and research analyses of static perimetry data. Topographic models of the HOV aid the visualization of field defects, and topographically derived indices quantify the magnitude and extent of visual field sensitivity.Translational Relevance: VFMA assists with the interpretation of visual field data from any perimetric device and any test location pattern. Topographic models and volumetric indices are suitable for diagnosis, monitoring of field loss, patient counseling, and endpoints in therapeutic trials.Perimetry is a time-established test used in patients with glaucoma 1 and retinal degenerations, such as retinitis pigmentosa (RP) 2-4 for screening, disease detection, and classification, monitoring for progression, correlation with activities of daily life, and, more recently, structure-function studies. Because the earliest and most disabling features of many forms of inherited retinal degeneration involve visual field loss, most often in the periphery, testing the entire visual field is crucial for the evaluation and monitoring of these patients. The most common means of fullfield testing is kinetic perimetry, which can efficiently locate the borders of seeing areas. In comparison, static perimetry can better define small sensitivity

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Spatial Pattern of Glaucomatous Visual Field Loss Obtained with Regionally Condensed Stimulus Arrangements

Cited by 116 publications

References 43 publications

A Test of a Model of Glaucomatous Damage of the Macula With High-Density Perimetry: Implications for the Locations of Visual Field Test Points

A Test of a Model of Glaucomatous Damage of the Macula With High-Density Perimetry: Implications for the Locations of Visual Field Test Points

Diagnostic ability of Humphrey perimetry, Octopus perimetry, and optical coherence tomography for glaucomatous optic neuropathy

VFMA: Topographic Analysis of Sensitivity Data From Full-Field Static Perimetry

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