July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Effect of fundus tracking on perimetric test retest-variability
Author Affiliations & Notes
  • Susan R Bryan
    Optometry and Visual Sciences, City, University of London, London, United Kingdom
  • Giovanni Montesano
    Optometry and Visual Sciences, City, University of London, London, United Kingdom
    Eye Clinic, University of Milan, Milan, Italy
  • Luca Mario Rossetti
    Eye Clinic, University of Milan, Milan, Italy
  • Paolo Fogagnolo
    Eye Clinic, University of Milan, Milan, Italy
  • Francesco Oddone
    Glaucoma Unit, IRCCS GB Bietti Eye Foundation, Rome, Italy
  • Allison M McKendrick
    Optometry & Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
  • Andrew Turpin
    Computing and Information Systems , University of Melbourne, Melbourne, Victoria, Australia
  • Paolo Lanzetta
    Department of Ophthalmology, University of Udine, Udine, Italy
  • Andrea Perdicchi
    Azienda ospedaliera Sant'Andrea, Rome, Italy
  • Chris A Johnson
    Ophthalmology & Visual Sciences, University of Iowa, Iowa City, Iowa, United States
  • David F Garway-Heath
    Institute of Ophthalmology, University College London, London, United Kingdom
    NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, United Kingdom
  • David P Crabb
    Optometry and Visual Sciences, City, University of London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Susan Bryan, None; Giovanni Montesano, None; Luca Rossetti, CenterVue (C); Paolo Fogagnolo, CenterVue (C); Francesco Oddone, CenterVue (C); Allison McKendrick, CenterVue (C); Andrew Turpin, CenterVue (C); Paolo Lanzetta, CenterVue (C); Andrea Perdicchi, None; Chris Johnson, CenterVue (C); David Garway-Heath, ANSWERS (P), CenterVue (C), Moorfields MDT (P), T4 (P); David Crabb, Allergan (R), ANSWERS (P), CenterVue (C), Roche (F), Santen (R), T4 (P)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 6030. doi:
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      Susan R Bryan, Giovanni Montesano, Luca Mario Rossetti, Paolo Fogagnolo, Francesco Oddone, Allison M McKendrick, Andrew Turpin, Paolo Lanzetta, Andrea Perdicchi, Chris A Johnson, David F Garway-Heath, David P Crabb; Effect of fundus tracking on perimetric test retest-variability. Invest. Ophthalmol. Vis. Sci. 2018;59(9):6030.

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

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Abstract

Purpose : To compare test – retest variability of measurements from a fundus tracking perimeter, designed to compensate for eye movements, with and without tracking enabled.

Methods : Compass fundus perimetry (CMP; Centrevue, Padua) was performed on 33 people with glaucoma and 51 age related normals. Each participant was examined twice with tracking compensation on (Tracking ON) and twice with tracking off (Tracking OFF), randomized.
Sensitivity measurement at each visual field location was determined from a Bayesian threshold strategy (ZEST).
Test – retest variability was estimated globally using absolute difference between mean sensitivities (using Bland - Altman plots) and across all test locations (pointwise) using the mean absolute deviation (MAD).
A mixed effect model was used to examine differences between the two testing conditions and to explore the effect of fixation instability measured by Bivariate Contour Ellipse Area (BCEA) and pupil size.

Results : The 95% limits of agreement for test-retest mean sensitivity were reduced by 31% in the Tracking ON condition in glaucoma subjects and by 28% in normals (Figure 1).
MAD was significantly reduced in the Tracking ON condition both in normals (0.28 ± 0.18 dB difference, 13% reduction, p = 0.046) and glaucoma subjects (0.63 ± 0.17 dB difference, 21% reduction, p = 0.0004).
Pupil size and BCEA had no significant associations with MAD in either testing condition.

Conclusions : Fundus tracking reduces measured test – retest variability in perimetry. No association between fixation stability (BCEA) and variability could be detected in the Tracking OFF condition. Different metrics of fixation might help clarify its contribution. Pointwise MAD showed the greatest improvement, indicating a role of the tracking in obtaining repeatable localized stimulations. Fundus tracking might have a role in improving repeatability, facilitating progression detection.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Figure 1. Bland – Altman plots for Tracking OFF (in red) and Tracking ON (in blue) with 95% limits of agreement (shaded region) and mean difference (solid line).

Figure 1. Bland – Altman plots for Tracking OFF (in red) and Tracking ON (in blue) with 95% limits of agreement (shaded region) and mean difference (solid line).

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