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Michael Wall, Carrie K. Doyle, Trina L. Eden, Chris A. Johnson, Monella M. Tamegnon, Gideon J. Zamba; Detection of Glaucomatous Progression Using Stimulus Size V. Invest. Ophthalmol. Vis. Sci. 2012;53(14):201.
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Stimulus size V has lower retest variability, greater dynamic range and similar ability to detect glaucoma. It therefore is a strong candidate to detect glaucomatous progression. Our aim was to test the hypothesis that standard automated perimetry using a size V stimulus would detect progression before size III.
Sixty (60) normal subjects and 120 glaucoma patients were tested twice at baseline and every six months for 4 years with SITA standard size III and Full Threshold size V. We used the PLRA2 method of pointwise linear regression (progression confirmed at two or more locations). We chose slope and significance values so that the criteria for identifying progression had similar specificities. Using a slope of -1.2 dB / year at a p = 0.04 for size III and -1.0 dB significance level the sensitivity (hit rate)/specificity ratios of size III to size V were 38%/93% and 35%/92%. Kaplan Meyer curves were used to compare the tests.
The glaucoma patients were 66.99 ± 9.55 years with mean deviation of -9.53 ± 6.13; normals were 61.2 ± 8.9 years with mean deviation 0.11 ± .99. Kaplan Meyer curves showed no significant differences between the two tests (p = .21).
Standard automated perimetry using Size III and size V stimuli have similar abilities to identify glaucomatous visual field progression. Given its greater dynamic range, size V stimuli have promise for following patients with moderate to severe stages of glaucomatous visual field damage.
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