Abstract
This study aimed to compare the diagnostic capability of Pulsar perimetry (Pulsar) in pre-perimetric glaucoma (PPG) and early glaucoma (EG) with that of Flicker perimetry (Flicker) and spectral-domain optical conference tomography (SD-OCT). This prospective cross-sectional study included 25 eyes of 25 PPG patients, 35 eyes of 35 EG patients, and 42 eyes of 42 healthy participants. The diagnostic capability using the area under the curve (AUC) of the best parameter and agreement of detectability between structural and functional measurements were compared. For PPG patients, the AUC of Pulsar, Flicker, OCT-disc, and OCT-macular was 0.733, 0.663, 0.842, and 0.780, respectively. The AUC of Flicker was significantly lower than that of OCT-disc (p = 0.016). For EG patients, the AUC of Pulsar, Flicker, OCT-disc, and OCT-macular were 0.851, 0.869, 0.907, and 0.861, respectively. There was no significant difference in AUC among these methods. The agreement between structural and functional measurements expressed by kappa value ranged from −0.16 to 0.07 for PPG and from 0.01 to 0.25 for EG. Although the diagnostic capability of Pulsar in the PPG and EG groups was equal to that of Flicker and SD-OCT, the agreements between structural and functional measurements for both PPG and EG were poor.
Highlights
Glaucoma is a chronic and progressive optic neuropathy associated with retinal ganglion cell death or dysfunction and with visual field disorder[1]
Of the 60 eyes of the 60 glaucoma patients, 25 eyes were classified as pre-perimetric glaucoma (PPG; 24 eyes with normal tension glaucoma and 1 eye with primary open angle glaucoma), and 35 eyes were classified as early glaucoma (EG; 20 eyes with normal tension glaucoma, 11 eyes with primary open angle glaucoma, and 4 eyes with secondary glaucoma)
We found that the diagnostic capability of Pulsar was equal to flicker perimetry (Flicker) and spectral-domain optical coherence tomography (OCT) (SD-OCT) for both PPG and EG patients
Summary
Glaucoma is a chronic and progressive optic neuropathy associated with retinal ganglion cell death or dysfunction and with visual field disorder[1]. Conventional SAP is the clinically accepted method for the diagnosis and assessment of glaucoma, SAP detectability of early glaucomatous visual field damage has been reported to be slightly inferior to the detectability of structural measurements by optical coherence tomography (OCT)[16, 17] and to functional measurements from non-conventional perimetry, such as short wave length automaed perimetry[18, 19], flicker perimetry (Flicker)[20, 21], Moorfields motion displacement test[22, 23], flicker defined form perimetry[24, 25], and frequency doubling technology (FDT)[26, 27]. The aim of this study was to assess the diagnostic capability of Pulsar for PPG and EG and to compare this capability with those of Flicker and SD-OCT
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