Frequency doubling technology perimetry abnormalities as predictors of glaucomatous visual field loss

Abstract

Purpose To determine whether frequency doubling technology (FDT) perimetry results predict glaucomatous visual field defects, as assessed by standard automated perimetry (SAP), in a glaucoma suspect population. Design Longitudinal observational study. Methods The study included 105 eyes of 105 glaucoma suspect patients, with a mean follow-up time of 41 ± 17 months. Glaucoma suspects had either intraocular pressure (IOP) higher than or equal to 23 mm Hg or glaucomatous optic neuropathy by stereophotograph assessment. All patients had normal SAP visual fields at baseline. A baseline FDT test was performed within 3 months of the normal SAP examination. Several baseline FDT parameters and other variables (age, gender, IOP, central corneal thickness, SAP visual field indices, and stereophotograph assessment) were investigated by univariate and multivariate Cox proportional hazards models to obtain hazard ratios (HR) and identify factors that predicted which patients had SAP glaucomatous visual field loss during follow-up. Results Seventeen patients (16%) developed repeatable SAP visual field abnormality during follow-up. An abnormal FDT examination at baseline predicted the development of SAP visual field conversion in both univariate (HR = 3.17; 95% confidence interval [CI] = 1.22–8.25; P = .018) and multivariate models (Adjusted HR = 3.68; 95% CI = 1.06–12.8; P = .04). The analysis of FDT examinations during follow-up revealed that in 59% of converters the FDT abnormalities preceded SAP visual field loss by as much as 4 years. Also, the initial development of glaucomatous visual field loss as measured by SAP occurred in regions that had previously demonstrated abnormalities on FDT testing. Conclusion Functional abnormalities detected by FDT perimetry were predictive of the future onset and location of SAP visual field loss among glaucoma suspect patients.