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Robert Stamper, Orathai Chansanti, Nita Subramanian, ; The ability of Moorfields Motion displacement visual field test to discriminate different stages of glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3954.
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© ARVO (1962-2015); The Authors (2016-present)
To determine if the Moorfield Motion Displacement Test (MMDT) can classify different stages of glaucoma, based on automated static perimetry (AVF) test results.
After informed consent was obtained, MMDT was performed in 270 patients (422 eyes) who had automated static perimetry done in the preceding year.. We used The Enhanced Supratheshold algorithm 99.5 pandora, which took approximately 2 minutes per eye. Patients were excluded if they had unreliable results in either AVF or MMDT. Criteria of exclusion were fixation loss > 25%, false positive > 33% and false negative > 33%. We classified the glaucoma patients into two groups depending on whether the mean deviation (MD) of the AVF was better than -6.00 or worse, according to the glaucoma staging system (GSS). We also analyzed the group of normal visual field in order to find the specificity. We compared 2 parameters from HVF to percentage of damage (PTD) from MMDT. One was MD vs PTD and other was VFI vs PTD. The scores on the MMDT were analyzed in a masked fashion and compared to the MD. A PTD of 70% was chosen as the cutoff point. We also reviewed the topographic pattern of visual field in both HVF and MMDT in a masked fashion.
There were 213 eyes where MD was better than -6.00 and 57 eyes with MD of -6.00 and worse. Specificity was relatively low: 90.4% of 136 eyes with normal automated static perimetry were also normal by MMDT. Sensitivity was high for moderate to advanced glaucoma; 98.9% of 57 eyes with moderate to advanced glaucoma had an abnormal MMDT. 76.6% of 77 eyes with early glaucoma (MD-1 to -5.99) had abnormal MMDT. However, there was some overlap. Receiver operator characteristic curves are in process and will be presented.
The MMDT was quite sensitive in detecting moderate to advanced glaucomatous visual field damage. However, using a 70% normal cutoff for the MMDT, the specificity was somewhat low. If an appropriate cutoff score for MMDT can be found that maintains the high sensitivity but improves the specificity, the MMDT might be an effective screening tool.
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