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Personalizing the Transition From 24-2 to 10-2 Visual Field Testing Using ARREST - A Simulation Study.

Andrew Turpin^1,2, William H Morgan^1,3, Allison M McKendrick^1,4,5

¹Lions Eye Institute, Perth, Australia.

Translational Vision Science & Technology

|August 1, 2025

Summary

This summary is machine-generated.

This study introduces an automated method (A10) to integrate detailed central vision (10-2) testing into standard peripheral (24-2) visual field tests for glaucoma. This approach enhances macular visualization without increasing test time or compromising glaucoma progression detection.

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Area of Science:

Ophthalmology
Visual Neuroscience
Medical Technology

Background:

Glaucoma diagnosis and monitoring typically involve a choice between peripheral (24-2) and central (10-2) visual field testing.
Current methods require clinicians to select either comprehensive peripheral or detailed central visual field assessment, but not both simultaneously.
This limitation can hinder the early detection of glaucomatous changes, particularly in the macula.

Purpose of the Study:

To evaluate an automated approach (A10) for integrating 10-2 visual field locations into the standard 24-2 test pattern.
To determine if this integrated approach can be achieved without increasing overall test duration.
To assess if the A10 method maintains or improves the ability to detect glaucomatous progression compared to standard 24-2 testing.

Main Methods:

The study utilized a previously developed ARREST approach, specifically adapting it to incorporate 10-2 pattern locations (A10).
Computer simulations were employed to compare the sensitivity of the A10 method against a standard ZEST procedure on the 24-2 pattern.
The simulation used synthetic longitudinal data from 126 glaucomatous eyes over 10 visits.

Main Results:

The A10 approach successfully incorporated 10-2 locations into 47 of 126 progressing visual field series.
Test durations were comparable between A10 (220 ± 27 presentations) and ZEST (226 ± 29 presentations).
Both methods demonstrated similar sensitivity in detecting progression, as indicated by Area Under the Curve (AUC) and survival time, with A10 offering superior macular visualization.

Conclusions:

The A10 approach enables automated, individualized integration of 10-2 visual field testing into the 24-2 pattern.
This method enhances spatial sampling in critical central areas without compromising peripheral visual field assessment.
The A10 strategy offers a valuable tool for more comprehensive glaucoma monitoring without extending patient test times.