Swedish Interactive Threshold Algorithm Research Articles

Relationship Between Retinal Oxygen Saturation and the Severity of Visual Field Damage in Glaucoma.

Increased oxygen saturation (StO 2 ) was significantly associated with the severity of visual field (VF) damage in patients with glaucoma. To investigate the association between retinal StO 2 percentage and the severity of VF loss in glaucoma. A total of 198 eyes from 131 patients with glaucoma were included in this cross-sectional study. Participants underwent imaging using ocular oximetry (Zilia) and 24-2 Swedish Interactive Threshold Algorithm standard VF (Carl Zeiss-Meditec). StO 2 (%) was measured at 2 locations of the peripapillary optic nerve head (superotemporal, and inferotemporal). Measurements were reported as the mean of at least 5 measurements in each location. Associations between the severity of VF loss, reported as mean deviation, and StO 2 (%) were calculated. A total of 198 eyes of 131 patients (mean (95% CI) age, 71.1 (68.9,73.3) years, 68 females (51.9%), and 63 males (48.1%) were analyzed. In univariable analysis, higher StO 2 -0.06 (-0.12, 0.00) was associated with severity in all hemifields ( P = 0.047). Multivariate regression analysis showed that each 1% increase in StO 2 was associated with -0.06 (-0.12, -0.00) dB loss in mean deviation in all hemifields ( P = 0.043). In multivariate regression analysis in the superior hemifields, higher StO 2 -0.07 (-0.16, 0.01) tended to be associated with superior hemifield severity ( P = 0.09). Retinal oximetry enabled the continuous quantitative measurement of retinal StO 2. Increased StO 2 was significantly associated with the severity of VF damage in patients with glaucoma.

Comparative Analysis of 24-2C, 24-2, and 10-2 Visual Field Tests for Detecting Mild-Stage Glaucoma With Central Visual field Defects

This study sought to identify the most effective testing program for detecting visual-field defects in mild-stage glaucoma with central visual-field defects. A multicenter, retrospective diagnostic testing evaluation. The study involved 93 eyes (83 patients) with mild-stage glaucoma (median mean deviation [interquartile range]: -1.79 [2.16] dB) with central visual-field defects and 69 eyes (63 patients; median mean deviation, -1.38 [2.31] dB) with mild-stage glaucoma without central visual-field defects, from Jikei University School of Medicine and Tajimi Iwase Eye Clinic. Patients underwent 10-2 Swedish Interactive Thresholding Algorithm (SITA) Standard, 24-2 SITA Standard, and 24-2C SITA Faster tests. Central visual-field defects were defined using 10-2 SITA Standard and optical coherence tomography (OCT). A detection power of 4 points in the 24-2 that coincided with 10-2 (Center4), 12 points that lie within 10° (24-2-12), and 22 points that lie within 10° of 24-2C (24-2C-22) were analyzed using receiver operating characteristic (ROC) curves based on logistic regression analysis, using total deviation (TD) and pattern deviation (PD) probability plots. Area under the receiver operating characteristic curve (AUC) of the Center4, 24-2-12, and 24-2C-22 tests. In the upper-central visual field, AUCs of the TD plot were 0.50 (0.40-0.58) for the Center4, 0.75 (0.67-0.83) for 24-2-12, and 0.85 (0.78-0.91) for 24-2C-22, with 24-2C-22 AUC significantly exceeding 24-2-12 AUC. For the PD plot, AUCs were 0.53 (0.44-0.63), 0.81 (0.74-0.89), and 0.84 (0.77-0.90), respectively. In the lower-central visual field, using a total plot, AUCs were 0.27 (0.18-0.36), 0.57 (0.47-0.69), and 0.57 (0.46-0.68) for the Center4, 24-2-12, and 24-2C-22, respectively. Using the PD plot in the upper field, AUCs were 0.27 (0.19-0.36), 0.64 (0.53-0.75), and 0.81 (0.72-0.90), respectively, with the AUC of the 24-2C-22 significantly exceeding that of 24-2-12. The 24-2C test was significantly faster than both the 24-2 and 10-2 tests, reducing testing duration by 46% and 52%, respectively. The 24-2C SITA Faster test is highly effective and efficient for detecting mild-stage glaucoma with central visual-field defects. This, and its reduced duration, makes it a valuable tool in clinical settings.

Three-year efficacy and safety of omidenepag isopropyl in patients with normal tension glaucoma.

To retrospectively evaluate the 3-year efficacy and safety of single-agent omidenepag isopropyl in patients with normal tension glaucoma (NTG). Retrospective. One hundred patients (100 eyes) who had newly been administered omidenepag isopropyl were enrolled in this study. Intraocular pressure (IOP) was compared at baseline and 6, 9, 12, 18, 24, 30, and 36 months after administration. The mean deviation values at baseline and 12, 24, and 36 months measured using the Humphrey visual field test (30-2 Swedish Interactive Threshold Algorithm standard) were compared. Adverse reactions and dropouts were assessed. IOP significantly decreased from 15.5±2.7 mmHg at baseline to 13.8 ±2.3 mmHg after 6 months, 13.9± 2.3 mmHg after 12 months, 13.9±2.3 mmHg after 18 months, 13.8±2.1 mmHg after 24 months, 13.9±2.0 mmHg after 30 months, and 13.6±1.7 mmHg after 36 months (P < 0.0001). There was no significant difference in the mean deviation values at baseline (-3.66±3.49 dB), 12 months (-3.41±3.80 dB), 24 months (-3.13±3.81 dB), and 36 months (-3.06±3.30 dB). Adverse reactions occurred in 11 patients (11.0%), including conjunctival hyperemia in 6 patients. Fifty-two patients (52.0%) were excluded from the analysis because they discontinued treatment either due to IOP measurement by NCT or the use of additional drugs. After the administration of omidenepag isopropyl, IOP in patients with NTG decreased within 3 years, visual fields were maintained, and safety was satisfactory. Thus, omidenepag isopropyl can be used as the first-line treatment for patients with NTG.

Visual Field Evaluation Using Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast in Patients With Glaucoma and Healthy Individuals.

To evaluate visual fields obtained with Zippy Adaptive Threshold Algorithm (ZATA) Standard and ZATA Fast from patients with glaucoma and healthy individuals. Fifty-five patients with glaucoma (median mean deviation [MD], -7.6dB; interquartile range [IQR], -15.3 to -2.6dB) and 22 healthy participants (median MD, -0.6dB; IQR, -1.7 to 0.2dB) performed ZATA Standard and ZATA Fast tests on a Henson 9000 perimeter and Swedish Interactive Thresholding Algorithm (SITA) Standard and SITA Fast tests on a Humphrey Field Analyzer. Tests were repeated within 90days (median, 14days; range, 7-26days) to evaluate the test-retest variability. The mean difference between the MD of the ZATA Standard and SITA Standard tests was 1.7dB (95% confidence interval [CI], 0.9-2.4). Between ZATA Fast and SITA Fast, it was 0.9dB (95% CI, 0.2-1.5dB). Although there were systematic differences between the distributions of sensitivity estimates with ZATA and SITA, they did not affect the overall representation of damage by these tests. ZATA Standard and ZATA Fast were approximately 30% and 6% faster, respectively, than the corresponding SITA tests. ZATA Standard and ZATA Fast are suitable for clinical practice. However, differences between ZATA and SITA tests suggest that they should not be used interchangeably when patients with glaucoma are followed over time. This study examined the characteristics of ZATA visual field tests in a clinical population, and it supports the adoption of these tests for assessing patients with glaucoma.

Association of WDR36 polymorphisms with primary open-angle glaucoma

Background: Various genes contribute to the pathophysiology of primary open-angle glaucoma (POAG). The WD repeat domain 36 (WDR36) gene may participate in T cell activation and, hence, in the pathogenesis of POAG. We investigated the association of two WDR36 gene single nucleotide polymorphisms (SNPs) with POAG.&#x0D; Methods: This cross-sectional study recruited patients aged &gt;40 years with POAG and investigated the rs10038177 and rs1971050 SNPs of WDR36 using polymerase chain reaction and direct DNA sequencing. All participants underwent comprehensive ocular examination, visual field assessment using the Swedish Interactive Threshold Algorithm standard 24-2 threshold test, and measurement of peripapillary retinal nerve fiber layer thickness (RNFLT) using spectral domain optical coherence tomography.&#x0D; Results: We enrolled 105 patients with a mean (standard deviation) age of 55.41 (8.56) years and a male-to-female ratio of 56 (53.3%) to 49 (46.7%), most of whom had a diagnosis of POAG for 2 to 5 years (60.0%). Most participants had diabetes (90.5%) but not hypertension (88.6%). There was a significant association of rs10038177 (P&lt;0.05), but not rs1971050 (P&gt;0.05), with family history of glaucoma. The association between rs10038177 and intraocular pressure was significant (P&lt;0.05), but that between rs1971050 and intraocular pressure was not (P&gt;0.05). No significant association was observed between mean cup-to-disc ratio and either SNP (both P&gt;0.05). For rs10038177, a significant association was found only with the RNFLT of the superior quadrant (P&lt;0.05), whereas for rs1971050, a significant association was found with the RNFLT of all four quadrants and average RNFLT (all P&lt;0.05). However, pairwise comparisons revealed no significant differences between genotypes (P&gt;0.05 for all pairwise comparisons). The association of rs10038177 with glaucoma severity was insignificant (P&gt;0.05), and most patients with the TC genotype (71.7%) had moderate severity. There was no significant association between rs1971050 and glaucoma severity (P&gt;0.05).&#x0D; Conclusions: We observed genetic links between some, but not all, characteristics of POAG and the rs10038177 and rs1971050 SNPs of WDR36. Follow-up studies on these and other WDR36 SNPs in populations with different genetic backgrounds are necessary to confirm this genetic association.

Comparison of the TEMPO binocular perimeter and Humphrey field analyzer

This study compared between TEMPO, a new binocular perimeter, with the Humphrey Field Analyzer (HFA). Patients were tested with both TEMPO 24–2 Ambient Interactive Zippy Estimated by Sequential Testing (AIZE)-Rapid and HFA 24–2 Swedish Interactive Threshold Algorithm (SITA)-Fast in a randomized sequence on the same day. Using a mixed-effects model, visual field (VF) parameters and reliability indices were compared. Retinal nerve fiber layer (RNFL) thickness was measured using Cirrus optical coherence tomography (OCT), and coefficient of determinations for VF and OCT parameters were calculated and compared using Akaike information criteria. 740 eyes (including 68 healthy, 262 glaucoma suspects, and 410 glaucoma) of 370 participants were evaluated. No significant differences were seen in mean deviation and visual field index between the two perimeters (P > 0.05). A stronger association between VF mean sensitivity (dB or 1/L) and circumpapillary RNFL was found for TEMPO (adjusted R2 = 0.25; Akaike information criteria [AIC] = 5235.5 for dB, and adjusted R2 = 0.29; AIC = 5200.8 for 1/L, respectively) compared to HFA (adjusted R2 = 0.22; AIC = 5263.9 for dB, and adjusted R2 = 0.22; AIC = 5262.7 for 1/L, respectively). Measurement time was faster for TEMPO compared to HFA (261 s vs. 429 s, P < 0.001). Further investigations are needed to assess the long-term monitoring potential of this binocular VF test.

Comparison between open-angle glaucoma and angle-closure glaucoma regarding the short-term optic disc vessel density changes after trabeculectomy

To compare the microvasculature of the optic disc in open-angle glaucoma (OAG) and angle-closure glaucoma (ACG) after trabeculectomy. This study included 34 patients divided into two groups based on the angle: (1) the OAG Group, which included 24 eyes from 24 patients, and (2) the ACG Group, which included ten eyes from 10 patients. All patients were subjected to comprehensive ophthalmic examinations. It included best-corrected visual acuity (BCVA), Goldmann applanation tonometry, gonioscopy, slit-lamp biomicroscopy, dilated fundus examination, and stereoscopic examination of the optic disc. The central corneal thickness was measured using a Nidek AL scan optical biometer. The visual field was evaluated by standard automated perimetry using Humphrey Field Analyzer (24–2 Swedish interactive threshold algorithm; Carl-Zeiss Meditec, Dublin, CA). Moreover, optical coherence tomography angiography (OCT-A) was performed utilizing the RTVue XR Avanti scanner (Optovue Inc., Fremont, CA, USA) preoperatively as well as 1 month after surgery. There was a statistically significant increase in optic disc vessel density (VD) in the whole image, radial peripapillary, inferior, superior, temporal, and nasal quadrant in OAG after surgery. Regarding the change in VD after surgery in ACG patients, there was a statistically significant increase in optic disc VD in the whole image, radial peripapillary, inferior, superior, temporal, and nasal quadrant in ACG after surgery.Regarding the percentage of VD change following trabeculectomy surgery, there were highly significant differences between the two groups for the whole image, radial peripapillary, inferior quadrant, and temporal quadrant VD. Statistically significant changes were also observed in the superior and nasal quadrants of VD. However, no significant change in VD was detected within the disc. In conclusion, the optic disc VD improved after the reduction of intraocular pressure (IOP) by surgery in both OAG and ACG. However, ACG demonstrated a significant improvement than the OAG.

Visual Function after Implantation of Diffractive Extended Depth-of-Focus Intraocular Lenses in Eyes with Primary Open-Angle Glaucoma.

The aim of this prospective study was to compare the visual functions of extended depth-of-focus intraocular lenses (EDOF IOLs) and monofocal IOLs in eyes with mild to moderate primary open-angle glaucoma (POAG). Cataractous eyes with POAG controlled using medical treatments, no central visual field defects, and mean deviation (MD) values of -10dB or better on the 30-2 test grid of the Swedish Interactive Threshold Algorithm standard program were included. Twenty-two eyes of 22 patients received EDOF IOLs (ZXR00V and ZXV150-375; J&J), whereas 24 eyes of 24 patients received monofocal IOLs (ZCB00V and ZCV150-375; J&J). MD values, corrected distance visual acuity (CDVA), and photopic contrast sensitivity were measured at 3months after surgery. Noninferiority of CDVA and contrast sensitivity in eyes with EDOF IOLs to eyes with monofocal IOLs were examined. The postoperative mean MDs of eyes with EDOF and monofocal IOLs were -2.76dB and -4.21dB with no significant difference. The CDVA of eyes with EDOF IOLs was noninferior to that of eyes with monofocal IOLs (P = 0.02). There were no inferiority in contrast sensitivity at any spatial frequency (P < 0.001). The visual function of EDOF IOLs in eyes with mild-to-moderate POAG was not inferior to that of monofocal IOLs. Registered in the Japan Registry for Clinical Research (identifier: jRCTs032200218).

Participant Experience Using Novel Perimetry Tests to Monitor Glaucoma Progression.

Participant surveys taken after using tablet-based and smart visual function analyzer (SVFA) perimetry tests suggest that patients may prefer novel perimetry tests over traditional visual field machines. Compare patient experience using the IMOvifa SVFA and the tablet-based Melbourne Rapid Fields visual field (VF) tests to the Humphrey Field 24-2 Swedish Interactive Threshold Algorithm Standard. Prospective observational cohort study on adult participants with diagnoses of glaucoma suspect, ocular hypertension, or glaucoma. Participants attended 2 study visits ~3 months apart. During the first visit, participants were trained to use the 2 novel perimeters, took 1 test on both new devices and the Humphrey Field Analyzer, then were surveyed. Participants received tablets and performed weekly tablet VF tests at home between study visits. At the final study visit, participants re-took the VF tests and completed the same surveys. Eighty-one participants were surveyed twice. At the baseline survey, participants preferred the SVFA (71.7%) and tablet tests (69.2%) over the Humphrey VF. Most were willing to perform weekly monitoring at home on the SVFA (69.1%) and tablet (75.4%). Participants generally had a "very good" overall experience when testing on the SVFA (71.6%) and tablet (90.1%). At the final visit, fewer participants were willing to test on the tablet daily (23.5% to 9.9%; P = 0.02 for change) and more were willing to test monthly (18.5% to 33.3%; P = 0.03 for change). Users reported a preference for novel VF devices. Overall participant experience using these devices was positive, supporting the feasibility of home monitoring of VFs from an experience perspective.

Decreased perifoveal ganglion cell complex thickness - a first sign for macular damage in patients using hydroxychloroquine.

Aim: To examine ganglion cell complex (GCC) thickness detected by optical coherence tomography (OCT) in patients using hydroxychloroquine (HCQ), without any structural and functional macular changes to evaluate the initial symptoms of macular toxicity for early diagnosis before clinical evaluation. Methods: Eighty eyes of forty patients (Group 1) and forty eyes of twenty healthy volunteer persons (Group 2) were included in the study. Detailed ophthalmologic and mydriatic fundus examination were applied to all patients and volunteers (controls). Spectral domain OCT, visual field (VF) and color vision test were performed. Measurements of macula thickness, GCC thickness (involving nerve fiber layer, ganglion cell layer and inner plexiform layer) and peripapillary retinal nerve fiber layer (RNFL) were performed with OCT. Patients with retinal pigment epithelial changes, VF paracentral scotoma and defected color vision were excluded from the planned study. Results: Perifoveal GCC layer thickness in all quadrants was significantly thinner in group 1 compared to group 2 (p=0.017, p=0.001, p=0.019, p=0.001). The mean global inferior hemifield and nasal quadrant RNFL thickness were lower than in the control groups (p=0,012, p=0,009, p=0,005, respectively). Conclusion: Changes in the thickness of nerve fiber layer and ganglion cell layer detected by optical coherence tomography can be thought to be used as a diagnostic aid for the early diagnosis of hydroxychloroquine-toxic maculopathy Abbreviations: GCC = Ganglion cell complex, OCT = Optical coherence tomography, HCQ = Hydroxychloroquine, BCVA = Best-corrected visual acuity, IOP = Intraocular pressure, VF = Visual field, RNFL = Retinal nerve fiber layer, SD OCT = Spectral-domain optical coherence tomography, mfERG = Multifocal electroretinogram, FAF = Fundus autofluorescence, IS/ OS = Inner segment-outer segment junction, SITA = Swedish Interactive Threshold Algorithm, RA = Rheumatoid arthritis, SLE = Systemic lupus erythematosus, SS = Sjogren syndrome.

Factors Affecting Visual Acuity and Central Visual Function in Glaucoma Patients With Myopia

To investigate associated factors including structural parameters of myopia and vessel density (VD) using optical coherence tomography angiography (OCT-A) to visual acuity (VA) and central visual function in glaucoma patients with myopia. Retrospective cross-sectional study METHODS: Sixty-five eyes of 60 glaucoma patients with myopia and without media opacity and retinal lesions were include. Both Swedish interactive thresholding algorithm (SITA) 24-2 and 10-2 visual field (VF) testing were performed. Superficial and deep VD in the peripapillary and macular regions were evaluated using OCT-A; retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform layer (GCIPL) thicknesses were measured. β-zone peripapillary atrophy (PPA) area, disc torsion, disc-fovea distance, and peripapillary choroidal thickness were measured. Decreased VA was defined as best-corrected VA <20/25. The worse mean deviation of SITA 24-2, thinner GCIPL thickness, and lower deep peripapillary VD were associated with the presence of central VF damage in glaucoma patients with myopia. Thinner GCIPL thickness, lower deep peripapillary VD, and longer disc-fovea distance were associated with decreased VA in logistic regression analysis. Thinner GCIPL thickness, lower deep peripapillary VD, and larger β-zone PPA area were associated with lower VA in linear regression analysis. Deep peripapillary VD showed a positive correlation with GCIPL thickness, whereas there was no relationship between deep peripapillary VD and RNFL thickness. Decreased VA in glaucoma patients with myopia was associated with lower deep peripapillary VD and papillomacular bundle damage. Lower deep peripapillary VD was independently associated with decreased VA along with thinner GCIPL thickness. Therefore, this could be stated that decreased VA in glaucoma patients is related to the damage location and the status of blood flow in the optic nerve head.

Comparing Static Perimetry Protocols of Central Field Testing among Patients with Glaucoma.

On comparing the Humphrey Field Analyzer (HFA) 24-2C Faster, which tests 10 additional points in the central field, with the 24-2 Swedish Interactive Thresholding Algorithm (SITA) Standard for detecting central field defects, we found that the HFA 24-2C Faster may be used for the initial field evaluation in glaucoma with the advantage of a shorter testing time. This study aimed to compare the HFA 24-2C Faster with the 24-2 SITA Standard and 10-2 among patients with glaucoma for the number of defective central points, global indices, and testing time. Sixty eyes of 60 patients with glaucoma and glaucomatous visual field defects on the 24-2 SITA Standard algorithm underwent the 24-2C Faster and 10-2 field tests. The number of central points detected, global indices, and reliability indices were compared between the 24-2C Faster and the 24-2 SITA Standard and 10-2 field tests. The 24-2C Faster, on average, detected 5.5 defective points more on the total deviation plot and 2 defective points more on the pattern deviation plot than the 24-2 SITA Standard in central 10°. The 10-2 algorithm detected 2.5 times more points on the total deviation plot than the 24-2C Faster. There was excellent consistency by an intraclass correlation coefficient of 0.95 for the mean deviation and 0.93 for the pattern standard deviation between the 24-2C Faster and the 24-2 SITA Standard. There was good consistency by an intraclass correlation coefficient of 0.80 for both mean deviation and pattern standard deviation between the 24-2C Faster and the 10-2. The testing time was significantly lower with the 24-2C Faster compared with the 24-2 SITA Standard and 10-2 test. Our study demonstrates that the HFA 24-2C Faster may be used for the initial evaluation of the visual field in glaucoma with the added advantage of a shorter testing time compared with the 24-2 SITA Standard program.

OPA1 Dominant Optic Atrophy: Pathogenesis and Therapeutic Targets.

OPA1 Dominant Optic Atrophy: Pathogenesis and Therapeutic Targets.

The Comparison of Foveal Sensitivity Between Diabetic and Non-diabetic Patients by Using Standard Automated Perimetry 10-2 Protocol: A Cross-Sectional Study.

Purpose The purpose of the study is to assess whether standard automated perimetry (SAP) was capable of detecting early neuroretinal changes by comparing foveal sensitivity in diabeticand non-diabetic subjects. Settings and design This is an observational and cross-sectional study that compared foveal sensitivity between a case group of 47 subjects with no or mild-to-moderate diabetic retinopathy (DR) without maculopathy and a control group of 43 healthy subjects. Materials and Methods After a thorough ocular examination, all patients were put through tests using a Humphrey visual field analyzerwith the Swedish interactive threshold algorithm (SITA) standard system (10-2 software). The primary indicator of success was the age-adjusted foveal awareness-esteem difference. Mean deviation (MD) and pattern standard deviation (PSD) readings were the supplementary performance indicators. Results The mean age of the case and control group was 50.76 ± 13.20 years and 49.90 ± 12.20 years, respectively. The probability of cataract development was higher in the case group (p< 0.0001). In the control group, 95.3% had best-corrected visual acuity (BCVA) in the category of good visual acuity (VA) (p < 0.0001). The mean foveal sensitivity in the case group was 28.57 ± 7.54 and 32.16 ± 7.09 for the control group, and the difference was statistically significant (p < 0.023). The mean of MD in the case group was -6.05 ± 7.93, whereas in the control group, it was -3.28 ± 1.70, which was found significant (p = 0.027). There was no difference in PSD between the study groups. Conclusions Foveal sensitivity decreased in diabetics, even without maculopathy, so SAP helps identify a patient at risk of future vision loss.

Comparison of Perimetric Outcomes from a Tablet Perimeter, Smart Visual Function Analyzer, and Humphrey Field Analyzer

The tablet-based Melbourne Rapid Fields (MRF) visual field (VF) test and the IMOvifa Smart Visual Function Analyzer (SVFA) are portable perimeters that may allow for at-home monitoring and more frequent testing. We compared tablet and SVFA results with outputs from the Humphrey Field Analyzer (HFA) 24-2 Swedish Interactive Threshold Algorithm Standard program. Observational cross-sectional study. Adult participants with a diagnosis of glaucoma, suspected glaucoma, or ocular hypertension seen in the Massachusetts Eye and Ear glaucoma clinic were enrolled. All participants were reliable and experienced HFA testers. Participants were tested with the SVFA and HFA. The study staff also trained participants on the MRF tablet with instructions to take weekly tests at home for 3 months. Visual field results from the 3 devices were compared. Mean deviation (MD), pattern standard deviation (PSD), reliability parameters, and point sensitivity. Overall, 79 participants (133 eyes) with a mean age of 61±13 years (range, 26-79 years) were included; 59% of the participants were female, and the mean HFA MD was-2.7±3.9 dB. The global indices of MD and PSD did not significantly vary between HFA and the 2 novel devices, except that the tablet VF reported a 0.6 dB higher PSD compared with HFA. However, tablet and SVFA sensitivities significantly differed from those of the HFA at 36 and 39 locations, respectively, out of 52 locations. Relative to HFA, the tablet overestimated light sensitivity in the nasal field while underestimating the temporal field. The SVFA generally underestimated light sensitivity, but its results were more similar to HFA results compared with the tablet. Although average MD values from the 2 novel devices suggest that they provide similar results to the HFA, point-by-point comparisons highlight notable deviations. Differences in specific point sensitivity values were significant, especially between the tablet and the other 2 devices. These differences may in part be explained by differences in the devices' normative databases as well as how MD is calculated. However, the tablet had substantial differences based on location, indicating that the tablet design itself may be responsible for differences in local sensitivities. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Comparing the structure-function relationship between the visual fields measured with variational Bayes linear regression and SITA standard.

We recently constructed an algorithm to measure visual field (VF) using the variational Bayes linear regression (VBLR). This algorithm enabled a faster VF measurement than the Swedish interactive thresholding algorithm (SITA) standard while maintaining the test-retest reproducibility (Murata H, et al. Br J Ophthalmol 2021). The current study aimed to compare the structure-function relationship between the SITA standard and VBLR. In 78 eyes of 56 patients with primary open-angle glaucoma, VF measurements were conducted using both SITA standard and VBLR VF, as well as spectral-domain optical coherence tomography. The structure-function relationship was investigated between visual sensitivity and circumpapillary retinal nerve fiber layer in the whole VF. This analysis was repeated for each of the 12 sectors (30 degrees). The strength of the structure-function relationship was evaluated using the second-order bias-corrected Akaike Information Criterion (AICc) index. In the whole VF, AICc values of SITA standard and VBLR were 601.6 and 597.3, respectively. The relative likelihood that VBLR had a better structure-function relationship than the SITA standard was 88.2% (when the entire field was averaged) or 99.9% (when all test points were analyzed in the pointwise manner). With the sector-wise analysis, SITA standard had a better structure-function relationship than VBLR in 1 sector (Superior sector in the retina), whereas VBLR had a better structure-function relationship than SITA standard in 4 sectors (Supero-Nasal, Infero-Nasal, Inferior, and Infero-Temporal sectors) with >95% relative likelihood. Although it depends on locations and similar between SITA standard and VBLR-VF, but VBLR-VF had a better structure-function relationship than the SITA standard overall.

A Novel Visual Field Screening Program for Glaucoma With a Head-Mounted Perimeter.

A novel visual field screening program with a head-mounted perimeter 'imo' could detect glaucoma at all stages in a short time with high accuracy. The present study aimed to examine the accuracy and availability of a novel glaucoma visual field screening program using a head-mounted visual perimeter 'imo.' Eyes of 76 non-glaucoma participants and 92 glaucoma patients were examined. All patients underwent visual field tests using the Humphrey Visual Field Analyzer (30-2 or 24-2 Swedish Interactive Thresholding Algorithm standard program) and imo (the visual field screening program). We evaluated five visual field screening program indicators: sensitivity, specificity, positive predictive value, negative predictive value, and testing time. We also evaluated the ability of this visual field screening program to differentiate between glaucoma patients and normal controls using the receiver operating characteristic curves and areas under the receiver operating characteristic curves. The sensitivity, specificity, positive predictive value, and negative predictive value of the visual field screening program were 76%-100%, 91%-100%, 86%-89%, and 79%-100%, respectively. The visual field screening program test time was 46±13 seconds for normal controls and 61±18, 82±21, and 105±16 econds, respectively for mild, moderate, and advanced-stage patients. The areas under the receiver operating characteristic curves were 0.77, 0.97, and 1.0 in the mild, moderate, and advanced stages, respectively. Visual field screening using a head-mounted perimeter 'imo' detected glaucoma at all stages in a short time with high accuracy.

Implantation of diffractive extended depth-of-focus intraocular lenses in normal tension glaucoma eyes: A case series

PurposeImplantation of presbyopia-correcting intraocular lenses (IOLs) has not been advised for glaucomatous eyes because of the risk of decreased contrast sensitivity with progress of glaucoma. Extended depth-of-focus (EDF) IOLs have been reported to provide comparable postoperative visual function and influence on the visual field to monofocal IOLs. MethodsThis case series was a retrospective medical record review of 16 eyes of 10 patients who had normal tension glaucoma (NTG) with no central visual field defects and underwent cataract surgery with implantation of diffractive EDF IOLs. At 3 months postoperatively, distance-corrected visual acuities (DCVAs) at distances of 5, 1, and 0.5 m and photopic contrast sensitivity were examined. Automated perimetry using the 30-2 Swedish interactive threshold algorithm was also performed, and the mean variance (MD) values, mean deviation values at the central four points (central MD), and foveal threshold were recorded. ResultsThe mean age of the patients (5 men, 5 women) was 66.5 years. Over 80% of eyes obtained DCVAs of 20/20, 20/20, and 20/25 at 5 m, 1 m, and 0.5 m, respectively. Whereas 5 of 16 eyes were categorized as severe by the Hodapp-Parrish-Anderson classification, postoperative contrast sensitivity was within the normal range, except for 4 eyes at 18 cycles per degree. Conclusions and importanceIn this case series, the postoperative visual functions of NTG patients with EDF IOLs were almost comparable to those of normal eyes with the same IOLs, which demonstrated that the use of EDF IOLs for controlled NTG eyes would be permissible. While careful patient selection and follow-up for NTG progress are important, further investigations are necessary for confirming the safety and exploring the selection criteria.

Structure–function relationship between central visual field and macular parameters in glaucoma patients

AbstractPurpose: To investigate the relationship between central visual field mean sensitivity (cVFMS) with macular vascularity, ganglion cell layer (GCL) thickness and ganglion cell complex (GCC) thickness in glaucoma patients.Methods: cVFMS was determined by Humphrey Field Analyser Swedish Interactive Thresholding Algorithm (SITA)‐faster 24‐2 and 24‐2C test grids. Foveal avascular zone (FAZ) parameters and macular vessel density (VD) was assessed by optical coherence tomography angiography (OCTA: AngioVue RTVue XR Avanti, Optovue). GCL thickness was measured by Spectralis‐OCT and GCC thickness by Optovue‐OCT. Relationship between vascular parameters, GCL and GCC thickness with cVFMS tested on 24‐2 and 24‐2C grids, was analysed by Pearson correlation coefficient. The comparison between correlation coefficients was performed by Steiger test.Results: Transversal study involving 50 eyes from 43 glaucoma patients. No significant correlation was found between FAZ area or perimetry and cVFMS. Instead, lower foveal vessel density (FD300) was associated with worse cVFMS in 24‐2 and 24‐2C grids (0.437, p = 0.006 and 0.438, p = 0.006, respectively). Significant correlations between macular VD and cVFMS were found both with 24‐2 and 24‐2C test grids: cVFMS24 versus whole VD (0.529, p = 0.001) and cVFMS24‐2C vs whole VD (0.553, p &lt; 0.001), cVFMS24 vs parafoveal VD (0.565, p &lt; 0.001) and cVFMS24‐2C vs parafoveal VD (0.602, p &lt; 0.001), cVFMS24 vs perifoveal VD (0.514, p = 0.001) and cVFMS24‐2C vs perifoveal VD (0.539, p &lt; 0.001). GCL and GCC thickness were also associated with cVFMS24 (0.566, p &lt; 0.001 and 0.568, p &lt; 0.001, respectively) and with cVFMS24‐2C (0.542, p &lt; 0.001 and 0.544, p &lt; 0.001, respectively). Worse superior hemi‐cVFMS 24‐2 and 24‐2C was significantly correlated with lower inferior hemimacular VD, GCL and GCC thickness. Similar results were obtained when comparing inferior hemi‐cVFMS with superior hemimacular parameters. No significant differences were detected between correlations with 24‐2 and 24‐2C grids.Conclusions: The FD300, but not FAZ area or perimetry, was correlated with cVFMS. Worse cVFMS was correlated with lower macular VD and lower GCL and GCC thickness both with 24‐2 and 24‐2C test grids.

Trigger happy" visual field: Ten pointers.

While performing the visual field test, some patients press the response button, at random and not in response to seeing a stimulus, resulting in a classical trigger happy visual field. This can be identified by 10 pointers as shown in this single field analysis printout of Humphrey visual field (HVF), 24-2, Swedish interactive threshold algorithm (SITA) standard test of the right eye. These points are useful teaching points for the students to recognize. The video describes classical 10 points, which can be identified in an HVF 24-2 printout in a patient with high false-positive (FP) error. The FP index is the most useful of the reliability indices. In SITA strategy, the FP rate is based upon the assessment of patient's reaction time over the entire course of the test, and hence is not calculated until the test is completed. Therefore, it is important for the perimetrist to be alert to recognize the signs early during the test, such as high fixation los s (despite good fixation as seen on screen monitor) and unusually high retinal sensitivity values (up to 50 dB), and reinstruct the patient. If the test is completed, it should be repeated. This is important as the FP rates >15% are associated with compromised test results and are automatically removed from the glaucoma progression analysis. https://youtu.be/UMVw2vkzdfQ.