The effect of macular visual field test density on central structure-function concordance in glaucoma

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Central visual field (VF) testing for glaucoma often uses high-density grids.
• The optimal number of test locations for maximizing structure-function concordance in the macula is not well-defined.

Purpose of the Study:

• To determine the impact of the number of test locations in central VF testing on binarized structure-function concordance in glaucoma patients.

Main Methods:

• 155 glaucoma patients' Humphrey Field Analyser (HFA) 10-2 and Cirrus optical coherence tomography Ganglion Cell Analysis (GCA) data were analyzed.
• Test locations were systematically reduced and increased from 36, evaluating binarized structure-function concordance (p<0.05).
• Eleven models were developed to analyze concordance rates as a function of test location number using nonlinear regression.

Main Results:

• Both subtractive and additive approaches indicated an optimal range of 8-14 test locations for structure-function concordance.
• Randomized test location selection yielded similar results to systematic approaches, emphasizing the number of locations over specific points.
• Structure-function concordance was optimized within this critical range across all tested models.

Conclusions:

• A critical number of 8-14 test locations optimizes binarized structure-function concordance in macular visual field testing.
• This finding provides a framework for developing integrated macular test locations for glaucoma VF testing.
• The number of test locations is more critical than their specific placement for optimizing concordance.