Abstract
Purpose :
Assessing the visual field of each eye under binocular simultaneous conditions has been shown to be faster than sequential monocular testing, while producing comparable outcomes. This study compares sequential versus simultaneous Standard Automated Perimetry (SAP) measured sequentially with the Humphrey Field Analyzer (HFA3, Zeiss Inc. Dublin, CA, USA), and simultaneously with the TEMPO/IMOvifa (Topcon Healthcare/CREWT Medical Systems, Tokyo, Japan), a novel binocular perimeter providing simultaneous, randomized binocular testing of each eye.
Methods :
33 normal subjects were recruited following exclusion of those with ocular/systemic disease. Training was given to minimize learning effects. Threshold tests were performed in the following sequence: HFA SITA-Fast 24-2 (right then left eye), TEMPO AIZE-Rapid 24-2 (simultaneous binocular test). Outcome measures were mean deviation (MD) and reliability indices (fixation loss (FL), false positive (FP) and false negative (FN) rates). Statistical analyses were performed using Student paired t-tests (p=0.05).
Results :
Mean age of the subjects was 58 years (range 22-72). With HFA, MD was -0.07 ± 1.33dB for the right eye (first eye) and -0.26±1.31dB for the left eye (second eye). With sequential testing (HFA), there was a trend for the first eye to perform 0.2 dB better than the second eye, but it did not reach statistical significance (p=0.28). With simultaneous testing (TEMPO), MD was similar for the two eyes with 0.24±0.42dB for right eye and 0.29±0.49dB for the left eye (p=0.34). There was no statistical difference between the sequential (HFA) and simultaneous (TEMPO) assessment of the right eye (p=0.16). The difference did reach significance (p=0.01) for the left eye, tested second on the HFA. Reliability indices (FL, FP, FN) showed no significant difference (p>0.05) between eyes, whether tested sequentially (HFA) or simultaneously (TEMPO).
Conclusions :
There was an observed 0.2dB reduction in MD for the second eye during sequential testing (HFA), but not between eyes tested simultaneously (TEMPO). The difference in MD values and the reliability indices between the two eyes, did not reach statistical significance for either sequential (HFA) or simultaneous (TEMPO) testing. Simultaneous binocular SAP measurement using TEMPO may limit the effects of patient fatigue on threshold, that can be experienced with traditional sequential assessment of monocular visual fields.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.