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Development of a test grid using Eye Movement Perimetry for screening glaucomatous visual field defects.

ABSTRACT: Eye Movement Perimetry (EMP) uses Saccadic Eye Movement (SEM) responses for visual field evaluation. Previous studies have demonstrated significant delay in initiation of SEMs among glaucoma patients in comparison with healthy subjects. The aim of the current study was to develop an EMP-based screening grid to identify glaucomatous visual field defects.An interactive test consisting of 36 locations and two stimulus contrasts (162 cd/m2 and 190 cd/m2 on a background of 140 cd/m2) was evaluated in 54 healthy subjects and 50 primary glaucoma patients. Each subject was presented a central fixation target combined with the random projection of Goldmann size III peripheral targets. Instructions were given to look at each peripheral target on detection and then re-fixate at the central fixation target while the saccades were assessed using an eye tracker. From each seen peripheral target, the Saccadic Reaction Time (SRT) was calculated for contrast level 162 cd/ m2. These values were used to plot Receiver Operating Characteristic (ROC) curves for each test locations and the Area Under the Curve (AUC) values were used to identify the locations with highest susceptibility to glaucomatous damage. Each stimulus location with an AUC less than 0.75 along with its mirrored test location around the horizontal axis were eliminated from the grid.The mean age was 48.1?±?16.6 years and 50.0?±?14.5 years for healthy subjects and glaucoma patients respectively. A significant increase of SRT values by 76.5% (p?

SUBMITTER: Kadavath Meethal NS

PROVIDER: S-EPMC5790865 | biostudies-other | 2018 Feb

REPOSITORIES: biostudies-other

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Development of a test grid using Eye Movement Perimetry for screening glaucomatous visual field defects.

Kadavath Meethal N S NS Mazumdar D D Asokan R R Panday M M van der Steen J J Vermeer K A KA Lemij H G HG George R J RJ Pel J J M JJM

Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 20171228 2

<h4>Background</h4>Eye Movement Perimetry (EMP) uses Saccadic Eye Movement (SEM) responses for visual field evaluation. Previous studies have demonstrated significant delay in initiation of SEMs among glaucoma patients in comparison with healthy subjects. The aim of the current study was to develop an EMP-based screening grid to identify glaucomatous visual field defects.<h4>Methods</h4>An interactive test consisting of 36 locations and two stimulus contrasts (162 cd/m<sup>2</sup> and 190 cd/m<s ...[more]

PMID: 29282563

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Project description:PurposeTo investigate patients' perception of glaucomatous VF loss and its association with glaucoma severity using the Amsler grid test.MethodsIn this prospective cross-sectional study, glaucoma patients with abnormal 10-2 Humphrey Swedish Interactive Threshold Algorithm-standard VF tests were enrolled consecutively. All patients underwent a black-on-white Amsler grid test for each eligible eye. They were asked to outline any perceived scotomas (areas with abnormal grid lines) on the grid and then describe verbally their perception of the scotomas. Examiners asked patients to clarify their descriptions. All descriptions used by patients were recorded in their own words, which were then sorted into descriptor categories according to similar themes. The number of descriptor categories was counted for each eye. 10-2 VF mean deviation (MD) was compared among eyes that reported different number of descriptor categories. The mean 10-2 VF MD values were compared among different descriptor categories.ResultsFifty glaucoma patients (88 eyes) were included. Patients used a total of 44 different descriptors for their scotomas. Patients' descriptors were classified into categories that incorporated similar themes, resulting in 4 overarching descriptor categories: Missing/White, Blurry/Gray, Black, and Not Aware. Fifty-two eyes reported one descriptor category and 19 eyes reported two descriptor categories (mean number of descriptor categories = 1.27±0.45). Eyes that reported two descriptor categories had worse VF MD than those that reported one (-17.86±10.31 dB vs. -12.08±7.53 dB; p = 0.012). When eyes were organized according to its combination of descriptor categories, each eye naturally sorted into one of the following 5 groups, in frequency order: Missing/White (27 eyes; 31%), Blurry/Gray (21 eyes; 24%), combined Missing/White and Blurry/Gray (19 eyes; 21%), Not Aware (17 eyes; 19%), and Black (4 eyes; 5%). The mean 10-2 VF MD severity order was Black (-21.18±10.59 dB), combined Missing/White and Blurry/Gray (-17.86±10.31 dB), Missing/White (-11.92±6.76 dB), Blurry/Gray (-10.55±7.03 dB), and Not Aware (-3.91±4.05 dB) (p<0.001).ConclusionParacentral vision loss in glaucoma is perceived by patients. As the perception of scotomas and the variety of terms to describe scotomas are related to glaucoma severity, clinicians should pay attention to patients' subjective descriptions of their glaucomatous VF loss. The historical notion that glaucoma patients lose their peripheral vision first and eventually look through a black tunnel needs to be updated to reflect the true perception of glaucoma.

Project description:PurposeRisk factors for visual field progression in glaucoma can affect both eyes, meaning that progression rates (in decibels per year) between eyes likely are correlated. We investigated whether incorporating information about the progression rate in one eye can improve the estimate of the rate in the fellow eye.DesignProspective cohort analysis.ParticipantsWe analyzed series of 10 visual field results drawn from the Portland Progression Project and the Rotterdam Eye Study.MethodsWe determined visual field progression rates using linear regression of the summary index mean deviation (MD) over time. We determined best-fitting linear models for the rates over the entire series based on the rate across n visual fields (n = 3 to 6) and used an analysis of variance to determine if incorporating the fellow eye's level of visual field damage (MD) or rate significantly improved these models.Main outcome measureVisual field progression rate (in decibels per year).ResultsVisual field progression rates were correlated positively between eyes for the 262 individuals analyzed (r = 0.51; P < 0.0001). For short series (n = 3 to 4), predicting the rate over the entire 10 fields was improved significantly by incorporating rate information from the fellow eye (P < 0.05), but not by incorporating knowledge about the level of damage in the fellow eye (P > 0.61). The fellow eye no longer aided predictions for n = 5 or 6 fields (P = 0.11 and P = 0.42, respectively). Although the coefficient quantifying the influence of the fellow eye's rate changed relatively little for n = 3 to 5 fields, the coefficient for the rate of the eye under consideration increased markedly with the n value.ConclusionsThe long-term rate of visual field change in an eye is, in part, predicted by the rate in the fellow eye, particularly when only a few visual field results are available for each eye. Because of this, apparent rapid progression in an eye is more likely to be real if the fellow eye also seems to be progressing rapidly.

Dataset Information

Development of a test grid using Eye Movement Perimetry for screening glaucomatous visual field defects.

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Development of a test grid using Eye Movement Perimetry for screening glaucomatous visual field defects.

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