Comparison of Conventional and High-Pass Resolution Perimetry in a Prospective Study of Patients With Glaucoma and Healthy Controls

Abstract

Objective: To determine whether high-pass resolution perimetry detected glaucomatous visual field progression earlier than conventional perimetry. Methods: In a prospective longitudinal study, we observed 113 patients with open-angle glaucoma and with early to moderate visual field damage and 119 healthy control subjects. Each subject underwent testing at 6-month intervals using conventional and high-pass resolution perimetry (program 30-2 of the Humphrey Field Analyzer [Humphrey Instruments, Inc, San Leandro, Calif] and the Ring program of the Ophthimus perimeter [Hi-Tech Vision, Gö teborg, Sweden], respectively). Our predetermined criterion for progression with conventional perimetry was the presence of at least 4 overlapping nonedge locations outside the fifth percentile for test-retest variability of threshold deviations (defined by the Glaucoma Change Probability Analysis of the Statpac 2 program) in 2 of 3 consecutive visual fields. We employed the identical criterion for progression with highpass resolution perimetry using our own test-retest variability data. We repeated this procedure in the controls to measure the false-positive rate of progression. Results: Patients were observed for a median of 4.5 years and 11 examinations with each technique. Fiftyseven patients (50.4%) did not show progression with either technique. Twenty-four patients (21.2%) showed progression with high-pass resolution perimetry alone, whereas 6 (5.3%) showed progression with conventional perimetry alone. Of the remaining 26 patients (23.0%) who showed progression with both techniques, 14 (54%) showed progression with high-pass resolution perimetry first (median, 12 months earlier); 5 (19%), with conventional perimetry first (median, 6 months earlier); and 7 (27%), with both techniques at the same time. Controls were observed for a median of 5 years and 11 examinations with each technique. One control (0.8%) showed progression with high-pass resolution perimetry. Conclusions: Our results suggest that high-pass resolution perimetry detects glaucomatous visual field progression earlier than conventional perimetry in most patients with progression.

Interexaminer and intraexaminer reliability of the microperimeter MP-1

“…27 These results suggest that either or both perimetric testing and early glaucomatous visual field loss may be inherently variable. 27 As reported in earlier investigations, the amount of variability is much higher in patients with glaucomatous visual field loss; [28][29][30] so the comparison with microperimetry in nonglaucomatous patients seems to be difficult.…”

Functional Testing in Glaucoma Diagnosis

“…Here, ring shaped stimuli of different sizes but with fixed contrast are presented at 50 different locations in the central 30°of the visual field [54,55]. Some evidence suggests that HPRP may be able to diagnose early glaucomatous damage [56,57]. For example, Iester et al compared SAP (HFA 30-2), FDT (C-20), and HPRP parameters in 52 eyes determined to have glaucoma by disc examination, visual field, or both and in 30 eyes with IOP of more than 21 mmHg but no other abnormalities.…”

Clinical assessment of optic nerve disorders

“…Other visual field techniques include short wavelength (blue on yellow) automated perimetry (SWAP), [25][26][27][28] highpass resolution (ring) perimetry (HRP) aimed at testing the parvocellular pathway, 29,30 flicker (Medmont automated) perimetry, 31 motion perimetry, 26 and frequency doubling perimetry (FDP) aimed at testing the magnocellular pathway, and rarebit (microdot) perimetry. 32,33 Frequency doubling perimetry is widely used by optometrists, primarily screening for glaucoma.…”