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Screening with automated perimetry using a threshold-related three-level algorithm.

O Kosoko, A Sommer, C Auer

    Ophthalmology
    |July 1, 1986
    PubMed
    Summary
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    This study demonstrates that a reduced Humphrey Field Analyzer screening strategy can effectively identify glaucoma. The optimized approach maintains high accuracy while significantly decreasing testing time for glaucoma diagnosis.

    Area of Science:

    • Ophthalmology
    • Medical Technology
    • Diagnostic Imaging

    Background:

    • Glaucoma diagnosis relies on visual field testing, which can be time-consuming.
    • Automated perimetry, like the Humphrey Field Analyzer, offers standardized visual field assessment.
    • Optimizing screening strategies is crucial for efficient clinical practice.

    Purpose of the Study:

    • To evaluate the efficacy of a simplified screening strategy for glaucoma detection using the Humphrey Field Analyzer.
    • To determine if reduced testing parameters maintain diagnostic accuracy compared to standard methods.

    Main Methods:

    • Eighty eyes (24 glaucoma, 56 normal) were tested with a Humphrey Field Analyzer's automated threshold-related, three-level screening strategy.
    • Goldmann perimetry served as the gold standard for comparison.

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  • Statistical algorithms were applied to differentiate glaucoma from normal eyes based on visual field defects.

    • Main Results:

    • A criterion of 17 or more absolute and/or relative defects identified 95% of glaucoma eyes and correctly screened out 80% of normal eyes.
    • These findings were validated on a separate cohort (25 glaucoma, 108 normal eyes).
    • A two-level strategy limited to the nasal field showed potential for substantial reduction in stimulus presentations without compromising sensitivity or specificity.

    Conclusions:

    • A modified, reduced screening strategy using the Humphrey Field Analyzer can effectively detect glaucoma.
    • Optimized visual field testing protocols can improve efficiency in glaucoma screening.
    • Further investigation into two-level, nasal-field-limited strategies may enhance diagnostic throughput.