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D.K. Varma, P.H. Artes, M.T. Nicolela, R.P. LeBlanc, B.C. Chauhan; Comparison of Three Psychophysical Tests for Detecting Glaucomatous Visual Field Progression . Invest. Ophthalmol. Vis. Sci. 2003;44(13):43.
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Purpose: To compare the performance of the Humphrey Field Analyser (HFA), High-pass Resolution Perimetry (HRP) and Frequency Doubling Technology (FDT) perimetry in detecting glaucomatous progression in a longitudinal prospective study. Methods: Seventy-one open-angle glaucoma patients were tested at six-monthly intervals using all three tests for a median duration of 3 years, with a median of 7 examinations with each test. For each test, points classified as progressing were determined using event analyses based on the Glaucoma Change Probability analysis with confirmed progression in 2 of 3 consecutive tests. To permit comparisons between the three tests, the progression criteria for the number of points were adjusted to yield approximately the same number of progressing patients with each technique (3 points with the HFA and Ring, 2 with FDT to yield 18, 21 and 21 progressing patients respectively). We looked at the overlap in patients identified as progressing with these tests as well as time to progression. The concordance in quadrant of progression and non-progression was assessed by assigning a score from 0-1. Results: Five patients progressed with both HFA and HRP, 6 with both HFA and FDT, and 6 with both HRP and FDT. Only 1 patient progressed with all three tests. No significant differences were found in the time to progression between the three methods. Patients progressing with both HFA and HRP showed a mean quadrant concordance score of 0.45 while the respective figures between HFA and FDT, and HRP and FDT were 0.29 and 0.83. Conclusions: HFA, HRP and FDT had a relatively poor overlap in the patients classified as progressing. In this sample, neither technique was able to show a significant advantage in terms of early detection. Agreement in the quadrant of progression was generally poor. This study suggests inherent differences in the mechanism of progression that each test is designed to detect.
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