Microperimetry, Humphrey field analyzer, and optical coherence tomography in detecting glaucoma: a comparative...

Area of Science:

• Ophthalmology
• Glaucoma diagnostics
• Visual electrophysiology

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Early and accurate diagnosis is crucial for effective management and vision preservation.
• Current diagnostic methods include visual field testing and optical coherence tomography, but their comparative performance requires further evaluation.

Purpose of the Study:

• To compare the diagnostic performance of microperimetry (MP), Humphrey Field Analyzer (HFA) visual field (VF) 10-2 and 24-2 tests, and spectral-domain optical coherence tomography (SD-OCT) in detecting POAG.
• To identify the most effective imaging or functional test for POAG diagnosis.

Main Methods:

• A prospective study involving 35 POAG eyes and 42 control eyes (age ≥50 years).
• VF testing using HFA and Macular Integrity Assessment.
• SD-OCT measurements of optic nerve head (ONH), retinal nerve fiber layer thickness (RNFLT), and ganglion cell inner-plexiform layer thickness (GCIPLT).
• Analysis of receiver operating characteristic curves (AUC) and sensitivity at 95% specificity for each parameter.

Main Results:

• Minimum GCIPLT (ganglion cell inner-plexiform layer thickness) demonstrated the highest diagnostic performance (AUC: 0.952) among SD-OCT parameters.
• HFA 24-2 (AUC: 0.950) outperformed the HFA 10-2 test (p=0.036) in differentiating POAG from control eyes.
• GCIPLT measurements showed significantly better performance than HFA 10-2 (p=0.015).
• MP showed comparable performance to HFA 10-2, suggesting a complementary role.

Conclusions:

• GCIPLT measurements exhibit the highest diagnostic accuracy for detecting POAG.
• The HFA 24-2 visual field test is more effective than the HFA 10-2 test for distinguishing POAG.
• Microperimetry can serve as a valuable complementary tool in POAG diagnosis.