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Abstract
PURPOSE: To evaluate short-wavelength-sensitive perimetry in the detection of glaucomatous field loss. METHODS: The sample consisted of 27 normal subjects, 24 patients with primary open angle glaucoma (POAG), and 27 patients with ocular hypertension (OHT). Blue-on-yellow (B-Y) and standard (W-W) perimetry was undertaken with a modified Humphrey Field Analyzer 640 on one eye of each subject and patient. The B-Y data were corrected for individual ocular media absorption. Results were compared to an age-matched normal database of 50 subjects (age range, 60 to 82 years; mean age, 70.0 years; SD, 6.4 years). Visual field indices and total and pattern deviation probability maps were calculated for both W-W and B-Y fields. RESULTS: The B-Y normal database exhibited increased between-subject variability compared to the W-W normal database (P < 0.001). The greater variability increased with the increase in eccentricity (P < 0.001) and with the increase in age (P = 0.032). All patients with POAG exhibited B-Y field loss; 11 demonstrated greater B-Y loss than the corresponding W-W field. In advanced POAG, the B-Y and the W-W fields were similar. Twenty-five of the 27 normal subjects exhibited normal B-Y fields. Five of the 27 patients with OHT manifested B-Y focal abnormality and a normal W-W field: in two, W-W focal loss subsequently developed. CONCLUSIONS: Short-wavelength-sensitive perimetry can identify visual field loss before that detected by W-W perimetry. However, the increased between-subject variability necessitates stringent statistical analysis in the definition of abnormality.