Increased Detection Rate of Glaucomatous Visual Field Damage With Locally Condensed Grids

Abstract

To compare detection rates of glaucomatous visual field defects (VFDs) between the conventional 6°ϫ 6°stimulus grid and locally condensed target arrangements in morphologically suspicious regions. Methods: A total of 66 eyes of 66 patients with glaucoma or patients suspected of having glaucoma (34 females and 32 males; age range, 14-85 years) were enrolled in this study. Individual, local target condensation was realized by fundus-oriented perimetry (FOP) using a campimeter and compared with the results of conventional automated perimetry (CAP), obtained with the Humphrey Field Analyzer (30-2 grid). Results: Twenty-three of the 66 patients showed normal findings with both methods; 27 had concordantly pathological results. In 15 patients we obtained normal findings with CAP, whereas FOP revealed early glaucomatous VFDs. Only one patient showed VFDs with CAP, whereas FOP results were normal. Scotoma detection rates significantly differed between the 2 methods (PϽ.001, sign test). Test duration with FOP was more than doubled compared with CAP. When considering only FOP points coinciding with the 6°spacing of the 30-2 grid, there was no longer a significant difference between FOP and CAP (PϾ.25, sign test). This indicated that the target pattern, rather than the perimetric device, was most relevant for detecting glaucomatous VFDs. Follow-up throughout a series of 3 subsequent sessions at 6-month intervals revealed repeatable results in more than two thirds of all eyes for both FOP and CAP. Conclusions: Fundus-oriented perimetry that uses individually condensed test grids significantly increases the detection rate of glaucomatous VFDs in morphologically conspicuous areas compared with CAP using equidistant (6°ϫ6°) target arrangements. Repeatability is comparable between both methods.

Glaucomatous damage of the macula

“…15C shows the same results after scaling and rotating to bring the disc centers into register. Although some inter-individual variation remains, scaling and rotating, as suggested previously (Schiefer et al, 2003; Jansonius et al, 2009), brought the RNFL bundle tracings approximately into agreement.…”

“…Jansonius et al (2009) substantially reduced individual differences in RNFL bundle projections by rotating and scaling the fundus images so that the centers of the fovea and disc were aligned (Schiefer et al, 2003). To confirm this scaling assumption, 9 fundus photos were selected by Dr. Randy Kardon at the University of Iowa from a large set based upon the clarity of the fiber bundles (Nguyen et al ARVO, 2012 abstract).…”

The connective tissue phenotype of glaucomatous cupping in the monkey eye - Clinical and research implications

“…Based in part on our findings in monkey imaging (Strouthidis et al, 2009a), and also on the same studies of RNFL anatomy and its relationship to structure-function correlation mentioned previously (Garway-Heath et al, 2000; Harwerth et al, 2010; Hood and Kardon, 2007; Jansonius et al, 2009; Jonas et al, 1989; Patel et al, 2012; Schiefer et al, 2003; Turpin et al, 2009), we have suggested (Burgoyne, 2015b; Chauhan and Burgoyne, 2013) that OCT data sets of the ONH, RNFL and macula should not only be regionalized relative to the FoBMO axis, but OCT data acquisition should be organized relative to it as well. Figures 43–47 illustrate our strategy for OCT phenotyping the ONH, RNFL and Macula of the monkey (and human) (Burgoyne, 2015a) eye.…”

“…The logic for using the FoBMO axis to regionalize ONH, RNFL, and macular anatomy has been suggested by previous studies of RNFL anatomy and its relationship to structure-function correlation (Garway-Heath et al, 2000; Harwerth et al, 2010; Hood and Kardon, 2007; Jansonius et al, 2009; Jonas et al, 1989; Patel et al, 2012; Schiefer et al, 2003; Turpin et al, 2009). As per our 2015 publication describing our LMA method (Lockwood et al, 2015), we estimate the location of the FoBMO axis relative to the vertical and horizontal axes of the embedded 3D HMRN so as to impose a consistent grid of twelve 30° sectors on the 3D HMRN LC anatomy of each eye (Figure 40).…”

Anatomic vs. Acquired Image Frame Discordance in Spectral Domain Optical Coherence Tomography Minimum Rim Measurements

“…Initial studies of the angle and distance between the fovea and the center of the ONH have been based on the clinical disc margin within a clinical photograph [19], [30], [31], or SLO reflectance image [5], [9], [32]. Patel et al[14] used the SDOCT-determined neural canal opening [33]–[35] (previous terminology that is equivalent to BMO) and fovea to co-localize RNFLT measurements from two different SDOCT instruments.…”