Evaluation of the Perimouse Online Suprathreshold Visual Field Test for Glaucoma Screening in a Chinese Population: A Comparison with the Humphrey Field Analyzer
Related Experiment Video
Updated: Oct 31, 2026
Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Xiaoyuan Shen1, Zidong Chen1, Kaixin Tan1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, People's Republic of China.
Purpose:
To evaluate the diagnostic performance and spatial agreement of an online suprathreshold perimeter (Perimouse) compared with the Humphrey Field Analyzer (HFA) for detecting glaucomatous visual field defects.
Patients And Methods:
In this prospective comparative study, 174 participants (283 eyes with open-angle glaucoma or healthy controls) underwent Perimouse suprathreshold program and HFA. Abnormal points (missed stimuli in Perimouse; points with P<0.5% on HFA total deviation map) were compared. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Point-wise performance used neural network-derived area under the curve (AUC) and Cohen's κ.
Results:
Perimouse abnormal-point counts were correlated with HFA abnormal-point counts (r = 0.88, P < 0.001) and negatively correlated with HFA mean deviation (r = -0.80, P < 0.001). The intraclass correlation coefficient for abnormal-point counts between Perimouse and HFA was 0.93, and Bland-Altman analysis showed a mean bias of 0.73 abnormal points, with 95% limits of agreement ranging from -10.70 to 12.17. A cutoff of five abnormal points achieved 85.9% sensitivity and 97.9% specificity (AUC = 0.97), with performance improving with disease severity. Point-wise κ values ranged from 0.32 to 0.78 (AUC, 0.67-0.96). The test duration for Perimouse was 2.64 ± 1.83 minutes.
Conclusion:
Perimouse demonstrated reasonable overall diagnostic accuracy for detecting HFA-defined visual field defects. Diagnostic performance was higher for moderate and advanced glaucomatous defects than for early defects, with variable point-wise agreement with HFA. Perimouse may serve as a rapid, adjunctive tool for preliminary functional screening of glaucomatous visual field loss.
