Diagnostic Power and Reproducibility of Objective Perimetry in Glaucoma.

Abstract

An objective perimetry method provides four 30-2 style reports in 8 minutes. These comprise sensitivity and delay reports for both eyes. A combined report format shows comparable diagnostic power to two forms of automated perimetry. To compare objective perimetry with two forms of standard automated perimetry (SAP) in glaucoma. The study cohort contained 40 persons with glaucoma (PwG) and 94 normal control subjects. The PwG had both perimetric and pre-perimetric eyes. Multifocal pupillographic objective perimetry was performed with the objectiveField Analyser® (OFA®), which independently assesses the visual fields of both eyes concurrently. Its OFA30 test assessed the central ±30°, and the OFA15 test assessed the central ±15°, both providing 30-2 style reports. The OFA tests were repeated two weeks apart to assess test-retest variability (TRV). OFA was compared with Matrix and HFA-SITA fast 24-2 threshold testing. Diagnostic power was quantified as area under receiver operating characteristic curves (AUROC). Test durations, Mean Defects and Pattern Standard Deviations of the 4 tests were compared. At a median of 4.09±0.02 minutes/eye the OFA tests were quicker than SAP (all P≤0.0001), 2 minutes/eye if OFA per-region sensitivities and delays are considered separately. The %AUROCs for OFA, Matrix and HFA were not significantly different, averaging 93±3% (mean±SD) in perimetric eyes, and 73±6% in pre-perimetric eyes. For moderate to severe fields OFA TRV was less than published results for SAP. OFA30 mean defects were significantly correlated between repeats (r=0.91), and with OFA15 (r=0.93, both P<0.0001). OFA provides extra functional measures in the form of per-region delays, and between-eye asymmetries. Both the OFA wide-field and macular tests provided comparable diagnostic power to SAP and better TRV in damaged eyes.