To evaluate the diagnostic ability of a new perimetric procedure in glaucoma.
Methods
Pulsar perimeter shows white circular sinusoidal grating patterns with decreasing amplitude, 5° in diameter, 500 msec in duration in 66 locations. The stimuli scale combines spatial resolution and contrast. The stimuli were shown with centrifugal wave motion at 8 cyl/deg (K6W) or pulse at 30 Hz (T30W). Fifty-six normal eyes and 82 eyes with ocular hypertension and mild glaucoma were included. These 82 cases were classified into four levels of diagnostic certainty, from 0 (ocular hypertension) to 3 (mild glaucoma).
Results
Mean examination time was 3:49 min. Specificity was 96.4% (T30W) and 94.6% (K6W). Sensitivities for levels 0 and 3 were 34.5% to 100% (T30W) and 24.1% to 75% (K6W). The receiver operating characteristic (ROC) curve areas for T30W at levels 1, 2, and 3 were 0.88, 0.94, and 0.99. The ROC areas for K6W were 0.83, 0.91, and 0.97. There was good correlation between both Pulsar perimetries (r=0.88), but it was lower with conventional perimetry (r=0.58 for T30W and r=0.59 for K6W).
Conclusions
The novel Pulsar T30W perimetry may be helpful for the study of mild glaucoma and ocular hypertension.
DranceS.M.The early structural and functional disturbances of chronic open-angle glaucoma. Ophthalmology1995; 92: 853–7.
2.
FrisenL.High-pass resolution targets in peripheral vision. Ophthalmology1987; 94: 1104–8.
3.
HartWMJr, SilvermanS.E., TrickG.L., NesherR., GordonM.O.Glaucomatous visual field damage. Luminance and color-contrast sensitivities. Invest Ophthalmol Vis Sci1990; 31: 359–67.
4.
SampleP.A., MartinezG.A., WeinrebR.N.Short-wavelength automated perimetry without lens density testing. Am J Ophthalmol1994; 118: 632–41.
5.
MotolkoM.A., PhelpsC.D.Contrast sensitivity in asymmetric glaucoma. Int Ophthalmol1984; 7: 45–50.
6.
QuigleyH.A.Identification of glaucoma-related visual field abnormality with the screening protocol of frequency doubling technology. Am J Ophthalmol1998; 125: 819–29.
ArdenG.B., JacobsonJ.J.A simple grating test for contrast sensitivity: preliminary results indicate value in screening for glaucoma. Invest Ophthalmol Vis Sci1978; 17: 23–32.
9.
SponselW.E., RitchR., StamperR.Prevent blindness America visual field screening study. Am J Ophthalmol1995; 120: 699–708.
10.
MitchelR.A.Contrast sensitivity in elderly subjects with a diagnosed ocular disease. Optom Vis Sci1993; 10: 102–6.
11.
SilvermanS.E., TrickG.L., HartW.M.Jr.Motion perception is abnormal in primary open-angle glaucoma and ocular hypertension. Invest Ophthalmol Vis Sci1990; 31: 722–9.
12.
TeohS.L., AllanD., DuttonG.N., FouldsW.S.Brightness discrimination and contrast sensitivity in chronic glaucoma-a clinical study. Br J Ophthalmol1990; 74: 215–9.
13.
RovamoJ., VirsuV., NasanenR.Cortical magnification factor predicts the photopic contrast sensitivity of peripheral vision. Nature1978; 271: 54–6.
14.
MonotA., ChirotA., CottinF., BourdyC.Exploration fonctionnelle spatiale par la fonction de sensiilité au contraste. Cas de sujects presbytes équipés de verres progressifs. J Fr Ophtalmol1986; 9: 199–209.
15.
ThibosL.N., SillD.L., BradleyA.Characterization of spatial aliasing and contrast sensitivity in peripheral vision. Vision Res1996; 36: 249–58.
16.
González-HernándezM., Fernández-VidalA., García-FeijooJ., González de la RosaM.Perimetric measurement of contrast sensitivity functions. In: HensonD.B., WallM., eds. Perimetry Update 2002–2003.Amsterdam: Kugler2004; 345–52.
17.
KorthM., HornF., StorckB., JonasJ.B.Spatial and spatiotemporal contrast sensitivity of normal and glaucoma eyes. Graefes Arch Clin Exp Ophthalmol1989; 227: 428–35.
18.
Falcão-ReisF., O'DonoghueE., BucetiR., HitchingsR.A., ArdenG.B.Peripheral contrast sensitivity in glaucoma and ocular hypertension. Br J Ophthalmol1990; 74: 712–6.
19.
NewsomeW.T., ParéE.B.A selective impairment of motion perception following lesions of the middle temporal visual area (MT). J Neurosci1988; 8: 2201–11.
20.
SampleP.A., WeinrebR.N.Color perimetry for assessment of primary open-angle glaucoma. Invest Ophthalmol Vis Sci1990; 31: 1869–75.
KoenderinkJ.J., BoumanM.A., Bueno de MesquitaA.E., SlappendelS.Perimetry of contrast detection thresholds of moving spatial sine wave patterns I. The near peripheral visual field (eccentricity 0 degrees-8 degrees). J Opt Soc Am1978; 68: 845–9.
26.
TylerC.W.Specific deficits of flicker sensitivity in glaucoma and ocular hypertension. Invest Ophthalmol Vis Sci1981; 20: 204–12.
BretonM.E., WilsonT.W., WilsonR., SpaethG., KrupinT.Temporal contrast sensitivity loss in primary open angle glaucoma and glaucoma suspects. Invest Ophthalmol Vis Sci1991; 32: 2931–41.
29.
González-HernándezM., Pareja RíosA., RodríguezM., González de la RosaM.Combined spatial resolution and contrast perimetry in normal subjects. In: WallM., MillsR., eds. Perimetry Update 2000/2001.Amsterdam: Kugler; 2001: 109–14.
30.
SokolS., DomarA., MoskowitzA.Utility of the Arden grating test in glaucoma screening: high false-positive rate in normals over 50 years of age. Invest Ophthalmol Vis Sci1980; 19: 1529–33.
31.
MoralesJ., WeitzmanM., González de la RosaM.Comparison between tendency-oriented perimetry (TOP) and Octopus threshold perimetry. Ophthalmology2000; 107: 134–42.
32.
WadoodA.C., Azuara-BlancoA., AspinallP., TaguriA., KingA.J.Sensitivity and specificity of frequency-doubling technology, tendency-oriented perimetry, and Humphrey Swedish interactive threshold algorithm-fast perimetry in a glaucoma practice. Am J Ophthalmol2002; 133: 327–32.
33.
WilenskyJ.T., JoondepthB.C.Variation in visual field measurements with an automated perimeter. Am J Ophthalmol1984; 97: 328–31.
34.
WildJ.M., Dengler-HarlesM., SearleA.E., O'NeillE.C., CrewsS.J.The influence of the learning effect on automated perimetry in patients with suspected glaucoma. Acta Ophthalmol1989; 67: 537–45.
35.
KulzeJ.C., StewartW.C., SutherlandS.E.Factors associated with a learning effect in glaucoma patients using automated perimetry. Acta Ophthalmol1990; 68: 681–6.
36.
González de la RosaM., MartínezA., SánchezM., MesaC., CordovésL., LosadaM.J.Accuracy of the tendency oriented perimetry (TOP) in the Octopus 1-2-3 Perimeter. In: WallM., WildJ., eds. Perimetry Update 1996/1997.Amsterdam: Kugler; 1997: 119–23.
37.
González de la RosaM., Martínez PiñeroA., González-HernándezM.Reproducibility of the TOP algorithm results versus the ones obtained with the bracketing procedure. In: WallM., WildJ., eds. Perimetry Update 1998/1999.Amsterdam: Kugler; 1999: 51–8.
38.
LachkarY., BarraultO., LefrancoisA., DemaillyP.Rapid tendency oriented perimeter (TOP) with the Octopus visual field analyzer. J Fr Ophtalmol1998; 21: 180–4.
HorikoshiN., OsakoM., GotoH., TamuraY., OkanoT.Clinical evaluation of tendency oriented perimetry in Octopus Perimeter. Jpn J Clin Ophthalmol1999; 53: 889–93.
41.
MaedaH., NakauraM., NegiA.New perimetric threshold test algorithm with dynamic strategy and tendency oriented perimetry (TOP) in glaucomatous eyes. Eye2000; 5: 747–51.
42.
AsmanP., HeijlA., OlssonJ., RootzénH.Spatial analyses of glaucomatous visual fields; a comparison with traditional visual field indices. Acta Ophthalmol1992; 70: 679–86.
43.
SampleP.A., MadridM.E., WeinrebR.N.Evidence for a variety of functional defects in glaucoma-suspect eyes. J Glaucoma1994; 3(Suppl): S5–18.
44.
GrahamS.L., DranceS.M.Interpretation of high-pass resolution perimetry with a probability plot. Graefes Arch Clin Exp Ophthalmol1995; 233: S140–9.
45.
YamashiroH., TanakaM., SaitoM., ShiratoS.The ability of frequency doubling technology to detect abnormality of visual function in early glaucoma. Nippon Ganka Gakkai Zasshi2001; 105: 488–93.
46.
BowdC., ZangwillL.M., BerryC.C.Detecting early glaucoma by assessment of retinal nerve fiber layer thickness and visual function. Invest Ophthalmol Vis Sci2001; 42: 1993–2003.
47.
CelloK.E., Nelson-QuiggJ.M., JohnsonC.A.Frequency doubling technology perimetry for detection of glaucomatous visual field loss. Am J Ophthalmol2000; 129: 314–22.
48.
FabreK., MichielsI., ZeyenT.The sensitivity and specificity of TOP, FDP and GDX in screening for early glaucoma. Bull Soc Belge Ophtalmol2000; 275: 17–23.
49.
QuigleyH.A., SanchezR.M., DunkelbergerG.R., L'HernaultN.L., BaginskiT.A.Chronic glaucoma selectively damages large optic nerve fibres. Invest Ophthalmol Vis Sci1987; 28: 913–20.
50.
PaczkaJ.A., FriedmanD.S., QuigleyH.A., BarronY., VitaleS.Diagnostic capabilities of frequency-doubling technology, scanning laser polarimetry, and nerve fiber layer photographs to distinguish glaucomatous damage. Am J Ophthalmol2001; 131: 188–97.
51.
BrusiniP., BusattoP.Frequency doubling perimetry in glaucoma early diagnosis. Acta Ophthalmol (Suppl): 1998; 227: S23–4.
52.
LandersJ., GoldbergI., GrahamS.A comparison of short wavelength automated perimetry with frequency doubling perimetry for the early detection of visual field loss in ocular hypertension. Clin Exp Ophthalmol2000; 28: 248–52.
53.
RodríguezJ., CordobésL., AbreuA., González de la RosaM.TOP flicker fluctuation in ocular hypertension. In: WallM., MillsR., eds. Perimetry Update 2000/2001.Amsterdam: Kugler; 2001: 149–53.
54.
SampleP.A., BosworthC.F., BlumenthalE.Z., GirkinC., WeinrebR.N.Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma. Invest Ophthalmol Vis Sci2000; 41: 1783–90.
