The Macula Progression Study (MAPS): Short-term variability of 10-2 visual fields for the detection of progression of central functional loss in glaucoma

Abstract

Purpose : 24-2 standard automated perimetry (SAP), with aid of computerized statistical softwares, is generally recommended for measuring progression in eyes with glaucomatous visual field (VF) loss.¹ However, compelling evidence show that 24-2 VFs can miss damage seen on 10-2 tests.² Despite growing interest in incorporating 10-2 tests in glaucoma practice, there is currently no commercially-available software for detecting progression with 10-2 VFs. To address this issue, herewith we describe a database based upon short-term variability of 10-2 metrics as a basis for detection of central field progression using event analysis.

Methods : We analyzed 56 patients (56 eyes) with established glaucoma and 24-2 MD >-6 dB from an ongoing prospective, longitudinal study. All participants had 10-2 VF tests (Carl Zeiss Meditec, Inc.) on the same day, which were repeated at 3±1 week intervals at least 4 times. We calculated the measures of center and dispersion of global (MD and PSD) and pointwise metrics from the 10-2 report. These measures were plotted to assess the relationship between severity and short-term variability.

Results : The mean (±SD) of the mean of 10-2 MD and PSD values were -1.52±1.9 dB and 2.42±2.1, respectively. The figures depict the relationship between 10-2 MD severity and its variability (based upon 10^th and 90^th percentiles of the data and the predicted 95% CI). The same analysis was performed for each of the 68 test locations’ threshold sensitivity, total deviation, and pattern deviation values. A similar pattern of increase in variability as a function of severity was observed.

Conclusions : We defined global and pointwise limits of short-term variability of 10-2 VF metrics which can be used to define 10-2 progression using an event-based approach.

REFERENCES
1) Spry PG, Johnson CA. Surv Ophthalmol. 2002
2) Hood DC et al. Prog Retin Eye Res. 2013

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.