Suprathreshold Approaches to Mapping the Visual Field in Advanced Glaucoma

Area of Science:

• Ophthalmology
• Visual Neuroscience
• Medical Technology

Background:

• Conventional perimetric sensitivity measurements are often unreliable in advanced glaucoma.
• Accurate mapping of visual field defects is crucial for managing advanced glaucoma.

Purpose of the Study:

• To evaluate suprathreshold tests on a high-density grid for efficient mapping of advanced visual field loss.
• To compare the accuracy and repeatability of two suprathreshold procedures against interpolated Full Threshold 24-2.

Main Methods:

• Simulations used data from 97 patients with mean deviation < -10 dB.
• Two suprathreshold procedures, Spatial Binary Search (SpaBS) and SupraThreshold Adaptive Mapping Procedure (STAMP), were tested on a 1.5° grid.
• STAMP used adaptive stimuli presentation and modified point status iteratively, stopping at 50%-100% of conventional test presentations.

Main Results:

• SpaBS showed worse mean accuracy and repeatability than Full Threshold (P < 0.0001).
• STAMP demonstrated slightly better mean accuracy compared to Full Threshold across all stopping criteria.
• STAMP achieved similar mean repeatability to Full Threshold, with statistical significance for accuracy noted at 100% conventional test presentations.

Conclusions:

• The SupraThreshold Adaptive Mapping Procedure (STAMP) can accurately and repeatably map advanced visual field defects.
• STAMP requires as few as 50% of conventional perimetric test presentations.
• Further research is needed to validate STAMP in human observers and for progressive visual field loss.