Distinguishing Between Normal and Early Glaucomatous Eyes Using Pulsar Perimetry

Abstract

Purpose: : To compare Pulsar perimetry with standard automated perimetry (SAP) in detecting early glaucomatous functional damage.

Methods: : One eye of 38 healthy subjects and 50 patients with early primary open–angle glaucoma (POAG) were evaluated. Visual fields (VFs) were assessed using SAP Humphrey Field Analyzer (HFA) 30–2 Full Threshold SITA standard test and Pulsar perimetry (Haag–Streit International). The Pulsar stimulus consists of circular sinusoidal grating patterns with decreasing amplitude, 5° in diameter, 500msec in duration, presented in 66 test locations. Spatial resolution and contrast of the stimulus are modified during the test. The stimuli were shown with a pulse motion with a TOP strategy (CP–T30W test). Mean deviation, loss variance, percentage of significantly abnormal points on the Deviation Probability plot and testing time were evaluated. Sensitivity and specificity of Pulsar perimetry in detecting early glaucomatous VF damage were calculated.

Results: : Sensitivity and specificity for Pulsar perimetry were 84% and 89.5%, respectively. Pulsar perimetry revealed a greater percentage of depressed points than SAP in the POAG eyes. Average testing time was 3.34 minutes.

Conclusions: : Pulsar perimetry appears to be a rapid and comfortable new perimetric procedure, providing higher sensitivity than SAP in detecting early glaucoma damage, which is probably related to Pulsar stimulus motion. It showed a tendency to amplify the SAP VF defects and requiring 50% less time than SAP using the Full Threshold test strategy.

Keywords: visual fields