Development of a test grid using Eye Movement Perimetry for screening glaucomatous visual field defects

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Eye Movement Perimetry (EMP) evaluates visual fields using Saccadic Eye Movement (SEM) responses.
• Previous research indicates delayed SEM initiation in glaucoma patients compared to healthy individuals.
• This study aimed to create an EMP-based screening tool for identifying glaucomatous visual field defects.

Purpose of the Study:

• To develop and validate an Eye Movement Perimetry (EMP) screening grid for glaucoma detection.
• To identify specific visual field locations most susceptible to glaucomatous damage using Saccadic Reaction Time (SRT).
• To refine the EMP test for efficient and accurate population-based glaucoma screening.

Main Methods:

• An interactive 36-location test with two stimulus contrasts was evaluated in 54 healthy subjects and 50 glaucoma patients.
• Saccadic Reaction Time (SRT) was measured using an eye tracker for each stimulus presentation.
• Receiver Operating Characteristic (ROC) analysis and Area Under the Curve (AUC) determined the most effective test locations, eliminating those with AUC < 0.75.

Main Results:

• Glaucoma patients exhibited a significant 76.5% increase in SRT compared to healthy subjects (p < 0.001).
• ROC analysis led to the elimination of 10 locations, resulting in a refined 26-location screening grid.
• The refined grid maintained significant SRT differences between healthy and glaucoma groups (p < 0.05).

Conclusions:

• A 26-location EMP screening grid was successfully developed, focusing on nasal, superior, and inferior visual field areas.
• The modified grid demonstrated a high screening accuracy of 90.4% in internal validation.
• This EMP-based approach shows promise as a tool for population-based glaucoma screening.