Comparison between Semiautomated Kinetic Perimetry and Conventional Goldmann Manual Kinetic Perimetry in Advanced Visual Field Loss

Abstract

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. Prospective, single-center, observational comparative case series. 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. 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. 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. 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.