Validation of a new static perimetric thresholding strategy (GATE)

Area of Science:

• Ophthalmology
• Visual electrophysiology
• Medical device software validation

Background:

• Automated static perimetry is crucial for diagnosing visual field defects.
• The German Adaptive Threshold Estimation (GATE) algorithm is a novel method for thresholding in perimetry.
• Validation of software implementations is essential for clinical adoption (NCT01265628).

Purpose of the Study:

• To validate the EyeSuite software version of the German Adaptive Threshold Estimation (GATE) algorithm.
• To assess the clinical agreement and performance of the EyeSuite GATE (GATEe) compared to its prototype (GATEp).

Main Methods:

• Comparison of local differential luminance sensitivity (DLS) and test times between GATEp and GATEe using modified Bland-Altman plots.
• Examinations were conducted on the Octopus 900 perimeter with visually impaired patients.
• Utilized grid 30A (30° eccentricity) and grid 84NO (90° eccentricity) test patterns.

Main Results:

• Good-to-acceptable agreement in local DLS values between GATEp and GATEe (bias <2 dB, LOA <5 dB).
• Very good repeatability for the prototype GATE (GATEp) (bias <0.5 dB, LOA <3 dB).
• Median test times were comparable: 7.8 min (GATEp) vs 8.8 min (GATEe) for 30° grid, and 6.7 min (GATEp) vs 7.8 min (GATEe) for 90° grid.

Conclusions:

• The EyeSuite version of GATE (GATEe) demonstrates good agreement with the prototype (GATEp) for local differential luminance sensitivity.
• The algorithm exhibits excellent repeatability.
• GATEe is recommended for clinical practice due to its validated performance in automated static perimetry.