Eye movements are altered by visual field loss, and these changes are related to changes in clinical measures. Eye movements recorded while passively viewing images could potentially be used as biomarkers for visual field damage.
Reading is often cited as a demanding task for patients with glaucomatous visual field (VF) loss, yet reading speed varies widely between patients and does not appear to be predicted by standard visual function measures. This within-person study aimed to investigate reading duration and eye movements when reading short passages of text in a patient's worse eye (most VF damage) when compared to their better eye (least VF damage). Reading duration and saccade rate were significantly different on average in the worse eye when compared to the better eye (P < 0.001) in 14 patients with glaucoma that had median (interquartile range) between-eye difference in mean deviation (MD; a standard clinical measure for VF loss) of 9.8 (8.3 to 14.8) dB; differences were not related to the size of the difference in MD between eyes. Patients with a more pronounced effect of longer reading duration on their worse eye made a larger proportion of “regressions” (backward saccades) and “unknown” EMs (not adhering to expected reading patterns) when reading with the worse eye when compared to the better eye. A between-eye study in patients with asymmetric disease, coupled with eye tracking, provides a useful experimental design for exploring reading performance in glaucoma.
Citation: Mönter VM, Crabb DP, Artes PH. Reclaiming the periphery: automated kinetic perimetry for measuring peripheral visual fields in patients with glaucoma. Invest Ophthalmol Vis Sci. 2017;58:868-875. DOI: 10.1167/iovs.16-19868 PURPOSE. Peripheral vision is important for mobility, balance, and guidance of attention, but standard perimetry examines only <20% of the entire visual field. We report on the relation between central and peripheral visual field damage, and on retest variability, with a simple approach for automated kinetic perimetry (AKP) of the peripheral field.METHODS. Thirty patients with glaucoma (median age 68, range 59-83 years; median Mean Deviation À8.0, range À16.3-0.1 dB) performed AKP and static automated perimetry (SAP) (German Adaptive Threshold Estimation strategy, 24-2 test). Automated kinetic perimetry consisted of a fully automated measurement of a single isopter (III.1.e). Central and peripheral visual fields were measured twice on the same day.RESULTS. Peripheral and central visual fields were only moderately related (Spearman's q, 0.51). Approximately 90% of test-retest differences in mean isopter radius were < 64 deg. Relative to the range of measurements in this sample, the retest variability of AKP was similar to that of SAP.
CONCLUSIONS.Patients with similar central visual field loss can have strikingly different peripheral visual fields, and therefore measuring the peripheral visual field may add clinically valuable information.
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