The visual acuities and the global indices measured using the full-threshold program (C-20 test pattern) of the commercial FDT perimeter are shown for each of the subjects with glaucoma in
Table 1 . Each of the subjects with glaucoma is identified by a unique symbol that can be used to identify individual performance in the figures.
Figure 2 shows the repeatability of the detection and resolution threshold measures for each subject group at both foveal and eccentric locations. The difference between the two-staircase threshold estimates determined for each subject is plotted with young normal, older normal, and glaucoma groups in the top, middle, and bottom panels, respectively. Each of the 10 subjects in each group (young normal subjects, older normal subjects, and glaucoma) is represented by a unique symbol. These symbols are retained in subsequent figures so that performance of individuals can be identified. Subjects tested at 7° are represented by unfilled symbols and subjects tested at 21° are represented by filled symbols. The foveal data represents all 10 observers in each group, whereas the eccentric data show the data of 5 observers only (as half of each group was tested at each location). For the data from the glaucoma group, it was assumed that the inner and outer rings of the FDT stimulus (
Fig. 1 , top) approximated eccentricities of 7° and 21°, respectively. A two-way repeated-measures ANOVA on the difference between the results of the two staircases (test–retest) was performed to determine whether the staircases were less repeatable for specific subject groups or locations (central versus periphery). For the detection and resolution tasks, no significant differences were found between groups (detection,
P = 0.82; resolution,
P = 0.46) nor locations (detection,
P = 0.72; resolution,
P = 0.57) and no significant interaction was found between group and location (detection,
P = 0.94; resolution,
P = 0.13). Pooling the data resulted in a mean ± SD difference between the two staircases of 0.03 ± 0.81 for the detection task and 0.13 ± 1.0 for the resolution task. This level of repeatability compares favorably with test–retest variability reported previously for FDT perimetry,
6 17 as does the observation that repeatability does not vary with deficit depth or eccentricity.
6
To determine whether the spatial structure of the FDT perimetry stimulus was visible at detection threshold, we compared performance on the detection and resolution-contrast threshold tasks. Detection- and resolution-contrast sensitivities are presented in
Figure 3 for the young normal, older normal, and glaucoma groups in the upper, middle, and lower panels respectively. Inspection of
Figure 3 reveals that in all three groups, detection sensitivity approximately matched resolution sensitivity. A two-way ANOVA on the difference data (resolution sensitivity minus detection sensitivity) showed no effect of group (
P = 0.40) or eccentricity (
P = 0.72), and so the data were pooled. No significant difference existed between the detection and resolution thresholds (95% confidence intervals for the mean of the pooled difference data, averaged for each observer [
df = 29]) = −0.53–0.23). This result implies that in all three subject groups, at both foveal and eccentric locations, the spatial structure of the frequency doubling grating was visible at the contrast threshold measured using the detection paradigm.
The next question was whether the spatial form appeared frequency doubled.
Figure 4 presents the apparent spatial frequency at the three different contrast levels tested for each of the subject groups. The left panels show data for the patch presented foveally, and the right panels, for the eccentric location. Apparent spatial frequency is displayed as a percentage of the true spatial frequency; hence, 100% represents veridical perception (that is, the grating appears to be its true spatial frequency), and 200% represents frequency doubling.
Several subjects reported that they could not confidently see the stripes at resolution-contrast threshold. This observation was expected, because the staircase procedure used to determine threshold converged at the 79% correct level. Matches were not obtained if after repeated attempts subjects were unable to make a match. Inspection of the middle and lower panels reveals that most of the older normal subjects and patients with glaucoma viewed the stimulus as closer to doubled (200%) than veridical (100%); however, there is considerable variation between subjects in the perceived spatial frequency with some subjects matching at frequencies greater than doubled. It should be noted that in general, individual subjects demonstrated similar trends of matching across all contrast levels. The low level of intraobserver variability on the task suggests that subjects were able to reliably perform the task at both central and peripheral locations. There was no significant difference in apparent spatial frequency between older normal subjects and patients with glaucoma at either eccentricity (two-way repeated-measures ANOVA: fovea, P = 0.81; eccentric, P = 0.93). Appearance of the FDT stimulus was also not altered in areas of glaucomatous visual field loss (foveal versus eccentric matches at 5 dB above resolution threshold in the glaucoma group, paired t-test; P = 0.64).
Comparison of the upper and middle panels of
Figure 4 reveals differences in the apparent spatial frequency observed by younger normal subjects and older normal subjects. The apparent spatial frequency was significantly lower in the young normal group than the old normal group at both eccentricities (two-way repeated measures ANOVA: difference between groups for central condition,
P = 0.015; for the peripheral condition,
P < 0.001).