High-Resolution Microperimetry for Detecting Glaucomatous Damage: A Prospective Evaluation of Performance

Area of Science:

• Ophthalmology
• Visual Neuroscience

Background:

• Glaucoma diagnosis relies on detecting visual field loss.
• Standard automated perimetry (SAP) is a common method for visual field testing.
• Optical coherence tomography (OCT) provides structural information about the optic nerve.

Purpose of the Study:

• To compare the efficacy of high-resolution microperimetry against SAP in identifying glaucomatous damage.
• To evaluate the diagnostic performance of microperimetry in conjunction with OCT findings.

Main Methods:

• 250 eyes underwent high-resolution microperimetry and SAP using distinct stimulus patterns.
• Glaucomatous damage was independently assessed by two graders using OCT scans (circumpapillary, optic disc, and widefield).
• Statistical analyses, including multivariable logistic regression and receiver operating characteristic curves, were employed.

Main Results:

• Both high-resolution microperimetry and SAP parameters (MTD, PSD) correlated with glaucomatous damage.
• High-resolution microperimetry showed significantly better performance (pAUC=0.86) than SAP (pAUC=0.75) in prediction models (p=0.007).
• Reduced resolution in microperimetry still outperformed SAP, indicating the value of higher sampling density.

Conclusions:

• High-resolution microperimetry offers enhanced detection of glaucomatous visual field defects compared to SAP.
• Fundus-tracking and higher-resolution sampling in microperimetry show significant potential for improving glaucoma diagnosis.