Automated flicker perimetry in glaucoma using Octopus 311: a comparative study with the Humphrey Matrix

Area of Science:

• Ophthalmology
• Visual Neuroscience

Background:

• Glaucoma diagnosis relies on visual field testing, but early detection remains challenging.
• Newer perimetry techniques aim to improve sensitivity in identifying early glaucomatous damage.

Purpose of the Study:

• To assess the clinical utility of flicker perimetry using the Octopus 311 perimeter.
• To compare flicker perimetry with standard automated perimetry (SAP) and frequency doubling technology (FDT) perimetry in glaucoma patients and suspects.

Main Methods:

• Evaluated 52 glaucoma patients, 26 glaucoma suspects, and 61 normal subjects.
• Utilized Octopus 311 for flicker perimetry, Humphrey Matrix for FDT perimetry, and Humphrey Field Analyzer for SAP.
• Assessed retinal nerve fiber layer thickness using Stratus OCT in glaucoma and suspect groups.

Main Results:

• Flicker perimetry demonstrated high diagnostic accuracy (AUC 0.96) in early glaucoma, exceeding Matrix perimetry (AUC 0.90).
• All tested methods showed near-perfect accuracy (AUC ≈ 1.0) in moderate to advanced glaucoma.
• Flicker perimetry at the 5% probability level showed significantly better performance than Matrix perimetry in glaucoma suspects.

Conclusions:

• The four-zone probability strategy with the Octopus 311 is a valuable tool for flicker perimetry.
• This method is effective for evaluating visual fields in early glaucoma and glaucoma suspect patients.