Pericentral Scotometry Guided by Standard Perimetry Using Microperimetry in Glaucoma Patients

To evaluate whether regionally customized high-density MP-3 microperimetry guided by regions of interest (ROIs) derived from standard automated perimetry (SAP) provides stronger structure-function correlations with ganglion cell layer thickness (GCLT) than conventional SAP in glaucoma.

This cross-sectional study included 85 eyes of 55 glaucoma patients. All participants underwent SAP (Octopus 900) and MP-3 microperimetry (Nidek Co. Ltd). Individual high-density grids were customized to target the quadrant of lowest mean sensitivity on SAP. Optical coherence tomography (DRI-OCT Triton) was used to measure mean GCLT in the corresponding quadrant (GCLTq). Structure-function relationships between GCLTq and visual field (VF) sensitivity indices were analyzed with linear mixed-effects models accounting for inter-eye correlation. VF sensitivities were expressed on logarithmic and linear scales. Comparative model performance was assessed using Akaike's Information Criterion (AIC), ΔAIC, and Akaike weights (w_i).

All VF indices correlated significantly with GCLTq (p < 0.05). MP-3 mean sensitivity on the linear scale (MS-MP3) showed the strongest association (R² = 0.139; p = 0.003), followed by MS-MP3 in dB (R² = 0.134; p = 0.003), SAP in dB (R² = 0.111; p = 0.008), and SAP on the linear scale (R² = 0.062; p = 0.021). Model comparison indicated a better fit for MP-3 on the linear scale (ΔAIC = 8; w_i = 0.982) than SAP, while differences on the dB scale were minor (ΔAIC = 2). The ROI-guided approach provided a wider sensitivity range and stronger spatial correspondence between functional and structural damage.

ROI-guided MP-3 microperimetry yielded a statistically supported yet modest improvement in structure-function correlation compared with SAP. The AIC-based analysis confirms that ROI targeting enhances the reliability and topographic accuracy of structure-function mapping in glaucoma.