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Jing Hou, Sean Wang, Jeremy Keenan, Brian Chon, Nita Subramanian, Tsontcho Ianchulev, Robert Stamper, Robert Chang, Ying Han; Comparison of Web-based Perimetry and office-based Humphrey Visual Field (HVF) in Patients with Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3938.
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© ARVO (1962-2015); The Authors (2016-present)
To compare a new online Perimetry (Peristat) with Humphrey visual field (HVF) for patients with mild, moderate and severe glaucoma.
Seventy-seven glaucoma patients with 129 eyes and 15 controls with 15 eyes were enrolled from the University of California, San Francisco and Stanford University. All subjects performed 24-2 SITA-standard HVF (Carl Zeiss Meditec, Dublin, CA) and Peristat (www.keepyoursight.org) in the office within 3 months. A reliable field for both tests was defined as fixation loss, false positive and false negative ≤ 33%. The severity of glaucoma was classified based on Hodapp-Anderson-Parrish criterion. The agreement between Peristat and HVF was graded per eye and per quadrant with Cohen’s Kappa. HVF defect in each quadrant was defined as clusters of ≥3 adjacent points with P ≤5% on the pattern deviation plot or ≥2 adjacent points with P ≤1%. Persitat defect in each quadrant was defined as clusters of ≥3 adjacent points with ≥ 6.7 dB loss from background or ≥2 adjacent points with ≥10 dB loss. An abnormal eye was identified if there was ≥1 abnormal quadrant.
Fifty-nine glaucoma patients with 78 eyes and 15 controls with 15 eyes obtained reliable HVF and Peristat tests. The numbers of eyes with mild, moderate and severe glaucoma were 47 (60.3%), 17 (21.8%), and 14 (17.9%), respectively. When fields were analyzed per quadrant, of the 312 quadrants, Cohen’s Kappas between the two tests for mild, moderate and severe glaucoma were 0.135 (95% Confidence Interval (CI): 0.011 to 0.259), 0.239 (95% CI: 0.089 to 0.390), and 0.301 (95% CI: 0.074 to 0.529), respectively. When fields were analyzed per eye, Cohen’s Kappas between the two tests for mild, moderate and severe glaucoma were 0.30 (95% CI: 0.119 to 0.486), 0.75 (95% CI: 0.524 to 0.978), and 0.86 (95% CI: 0.677 to 1.047), respectively. The sensitivity and specificity of Peristat to identify glaucomatous eye were 82.4% and 93.3% for moderate glaucoma, and 92.9% and 93.3% for severe glaucoma, respectively.
Web-based Peristat has a good to very good agreement with HVF to identify eyes with moderate and severe glaucoma. The spatial correlation between Peristat and HVF is fair for those eyes. Given that Peristat has high sensitivity and specificity to identify eyes with moderate to severe glaucoma, it could be a good glaucoma-screening tool.
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