What is the most suitable grid for computer perimetry in glaucoma patients?

Area of Science:

• Ophthalmology
• Visual Neuroscience

Background:

• Glaucoma diagnosis relies on visual field testing to detect characteristic patterns of vision loss.
• Accurate staging of glaucoma is crucial for effective treatment and management.

Purpose of the Study:

• To compare the diagnostic performance of two Humphrey Field Analyzer (HFA) threshold tests (30-1 and 30-2) in patients with glaucoma.
• To evaluate the impact of differences in scotoma detection on glaucoma staging.

Main Methods:

• 100 eyes with suspected or proven glaucoma were tested using the Humphrey Field Analyzer 620.
• Both 30-1 and 30-2 threshold tests, with complementary 6-degree grids forming a 4.2-degree grid, were employed.
• Results from 68 pathological fields were analyzed for differences in scotoma detection and staging.

Main Results:

• Significant differences in scotoma detection were observed between the 30-1 and 30-2 tests in 29 of 68 pathological fields.
• In 11 fields, these differences were substantial enough to potentially lead to incorrect glaucoma staging if only one test was considered.
• Scotoma detection frequency was markedly higher in central visual field areas compared to peripheral areas.

Conclusions:

• Current Humphrey Field Analyzer threshold tests (30-1 and 30-2) show considerable variability in scotoma detection, impacting glaucoma staging.
• Both tests should be utilized concurrently in glaucoma assessment to ensure comprehensive and accurate diagnosis.
• Future visual field testing programs may benefit from optimized grid densities tailored to different eccentricities for improved sensitivity.