Development of a new fully automated kinetic algorithm (program k) for detection of glaucomatous visual field loss.

Abstract

In Program K, a new automated kinetic algorithm that we developed, the frequency distributions of the number of patients' response points were obtained for external angles to distinguish normal and abnormal isopters. We also assessed the agreement between the results of Program K and Goldmann manual kinetic perimetry (MKP). Program K detected abnormalities in isopters by using the external angles of patients' response points. In experiment 1, a normal external angle range and endpoint for the algorithm were determined by using visual field (VF) results of 100 data sets. In experiment 2, the results of Program K and Goldmann MKP were compared in 63 virtual patients. Visual field loss was assessed by using stimuli of V/4e, III/4e, I/4e, I/3e, I/2e, and I/1e at a speed of 3 deg/s. The isopters by Program K and Goldmann MKP were overlapped and the area of intersection was expressed as a percentage of the union area. The intersection percentages and test durations were evaluated. A normal external angle range between 150° and 240° and phase 3 as the appropriate endpoint for the algorithm were determined. The intersection percentages for the six isopters were 84% (V/4e), 83% (III/4e), 78% (I/4e), 71% (I/3e), 60% (I/2e), and 50% (I/1e) (average, 71%). The average examination duration for Program K was 16.0 ± 3.2 minutes. The results of Program K and Goldmann MKP were comparable. Program K is clinically efficient and useful for detection and evaluation of abnormalities in a kinetic VF.