April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Using High-Density Perimetry to Test a Model of Glaucomatous Damage of the Macula and to Assess the Placement of Visual Field Test Points
Author Affiliations & Notes
  • Alyssa C Ehrlich
    Psychology, Columbia University, New York, NY
  • Matthew Nguyen
    Internal Medicine, Morehouse School of Medicine, Atlanta, GA
  • Ali S Raza
    Neurobiology and Behavior, Columbia University, New York, NY
  • Ieva Sliesoraityte
    Institut de la Vision, INSERM CIC 503, Paris, France
  • Andrea Mast
    Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
  • Ulrich Schiefer
    Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany
    Competence Centre “Vision Research”, University of Applied Sciences, Aalen, Germany
  • Donald C Hood
    Psychology, Columbia University, New York, NY
    Ophthalmology, Columbia University, New York, NY
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 5644. doi:
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      Alyssa C Ehrlich, Matthew Nguyen, Ali S Raza, Ieva Sliesoraityte, Andrea Mast, Ulrich Schiefer, Donald C Hood; Using High-Density Perimetry to Test a Model of Glaucomatous Damage of the Macula and to Assess the Placement of Visual Field Test Points. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5644.

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

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Abstract
 
Purpose
 

To use high-density perimetry to test a model [1] of local glaucomatous damage to the macula and to assess the placement of visual field (VF) test points used to detect this damage.

 
Methods
 

One eye from each of 31 patients with a glaucomatous arcuate VF defect in the central 10° of the upper hemifield was tested using a custom VF (Octopus, Haag-Streit, Inc.) with a rectangular 1°x1° test grid (double the test point density of the 10-2). Individual plots of total deviation (TD) from age-matched control values were generated, with point locations morphed as per displacement of retinal ganglion cells near the fovea.[2] A model, which predicts a “macular vulnerability zone” (MVZ, magenta in Fig. 1) and a less vulnerable region (cyan), was superimposed on each VF plot and aligned with patients’ fovea and disc centers by scaling and rotating.[3] The VF data were also used to simulate a 6° grid (like the 24-2) and the Octopus G program, as well as a 6° grid with 2 additional points. Three different pairs of points were chosen: (1) from the MVZ; (2) from the less vulnerable region; (3) by a MATLAB program that maximized the average number of abnormal points (TD≤-5 dB). All tests and simulations were restricted to the central ±10°.

 
Results
 

The average percent of VF points with TD≤-5 dB was significantly greater for the MVZ, 61.2% compared to 15.8% for the less vulnerable region (p<0.001; paired t-test). After scaling and rotating the model, these percentages were essentially the same, 61.7% and 15.3% (p=0.62, p=0.42). Moreover, the average number of abnormal points (see Table 1) was greater for the G program (3.94) than for the 6° grid (3.06). Yet this value was increased further by adding 2 points in the MVZ to the 6° grid (4.61), a value close to that for the pattern derived by empirical optimization (4.65).

 
Conclusions
 

The spatial pattern of high-density VF loss was consistent with the model, and scaling and rotating the model to align it with fovea and disc centers had little effect on this agreement. VF simulations suggest that the detection of glaucomatous damage to the macula could be improved by adding 2 test points in the MVZ to 6° grid test patterns (e.g. the 24-2). 1. Hood et al, PRER, 2013; 2. Raza et al, AO, 2011; 3. Jansonius et al, Vis Res, 2009.

 
 
Fig. 1. The model in field view with average VF TD values (dB).
 
Fig. 1. The model in field view with average VF TD values (dB).
 
 
Table 1. Results of VF simulations.
 
Table 1. Results of VF simulations.
 
Keywords: 642 perimetry • 758 visual fields • 612 neuro-ophthalmology: diagnosis  
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