September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Reliability of the Heidelberg Edge Perimeter (HEP) glaucoma screening compared to conventional 24-2-visual field tests in glaucoma patients
Author Affiliations & Notes
  • Matthias Marten Mauschitz
    German Center for Neurodegenerative Diseases, Bonn, Germany
  • Christian Karl Brinkmann
    Department for Ophthalmology, University of Bonn, Bonn, Germany
  • Frank G Holz
    Department for Ophthalmology, University of Bonn, Bonn, Germany
  • Monique M. B. Breteler
    German Center for Neurodegenerative Diseases, Bonn, Germany
  • Robert Patrick Finger
    Department for Ophthalmology, University of Bonn, Bonn, Germany
  • Footnotes
    Commercial Relationships   Matthias Mauschitz, None; Christian Brinkmann, None; Frank Holz, Heidelberg Engineering (F), Heidelberg Engineering (C), Optos (F), Zeiss (F); Monique Breteler, None; Robert Finger, None
  • Footnotes
    Support  This study was provided with the Heidelberg Edge Perimeter by Heidelberg Engineering
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3928. doi:
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      Matthias Marten Mauschitz, Christian Karl Brinkmann, Frank G Holz, Monique M. B. Breteler, Robert Patrick Finger; Reliability of the Heidelberg Edge Perimeter (HEP) glaucoma screening compared to conventional 24-2-visual field tests in glaucoma patients. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3928.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Visual field testing (VFT) is an essential part of glaucoma screening and diagnosis. Conventional VFT requires time and training and to date, no gold standard for a shortened glaucoma screening VFT exists. The Heidelberg Edge Perimeter (HEP; Heidelberg Engineering) offers a glaucoma screening VF test. However, its reliability has not been assessed compared to conventional 24-2 VFT. Thus, in this study we assess the sensitivity of the HEP screening compared to Humphrey Field Analyzer (HFA II; Zeiss) VFT

Methods : 75 patients and 25 controls (total n=100) were recruited at routine outpatient clinics. All individuals underwent the full HFA II 24-2° perimetry protocol , as well as the HEP glaucoma screening. The HEP screening tests 53 different locations within the central 24°. Locations are classified as normal, relative defect and absolute defect based on a normative database. For all individuals the percentage of screening locations classified as normal was calculated and compared to the HFA II Mean Deviation (MD) . Furthermore, the sensitivity with which the screening program could identify glaucoma patients with mild and with moderate or severe disease was assessed. Screening positive was defined as at least one location classified as non-normal. Severity of glaucoma was based on the MD by the HFA II (cut-off: mild 0 to -5dB, moderate -5 to -15 dB, severe < -15 dB)

Results : For all patients the median HFA II MD was -11.38 dB, the median percentage of locations classified as normal was 56.5 %. Over all individuals the Spearman correlation between the HFA II MD and the percentage of normal locations was 0.92. The overall sensitivity of the HEP screening to detect a glaucoma patient was 87%. When distinguishing between glaucoma severities, the sensitivity to detect mild cases was 60%, whereas for moderate or severe cases it was 100%. Median examination duration was 06:31 min for the HFA II and 01:59 min for the HEP Screening

Conclusions : The HEP glaucoma screening demonstrates very high sensitivity compared to the HFA II for moderate or severe glaucoma patients. However, it picked up only 60% of mild glaucoma patients. Based on our study the HEP screening might not be suitable to detect early stage glaucoma in a population study setting. Abnormal HEP screening results should lead to further visual field testing

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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