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Clin Exp Ophthalmol. 2013 Mar;41(2):140-7. doi: 10.1111/ceo.12016. Epub 2013 Jan 17.

High- versus low-density multifocal pupillographic objective perimetry in glaucoma.

Author information

1
The ARC Vision Centre, John Curtin School of Medical Research, Australian National University, Australia. ted.maddess@anu.edu.au

Abstract

BACKGROUND:

Multifocal pupillographic objective perimetry was compared using 24 and 44 regions per visual field.

DESIGN:

Experimental design in a university setting.

PARTICIPANTS:

Twenty-seven normal control and 36 age-matched glaucoma patients.

METHODS:

The four test variants differed in the mean interval between stimuli: 4, 1 or 0.25 s; and the number of visual field regions tested within the central 60 degrees: 24 or 44. All subjects had their diagnostic status confirmed by optical coherence tomography, two forms of perimetry and slit-lamp biomicroscopy. Both eyes were measured concurrently in 2.73 ± 0.45 min/eye (mean ± standard deviation), and tests were repeated about 2 weeks apart.

MAIN OUTCOME MEASURES:

The main outcome measures were: (i) mean change in light sensitivity due glaucoma; and (ii) areas under Receiver Operator Characteristic plots for detecting glaucoma.

RESULTS:

For all four variants, consensual responses, female gender and age produced small but significant sensitivity differences, and sensitivity declined with age by ≤-0.27 dB/decade (all P < 0.0003). The best diagnostic accuracy (area under curve 93.2 ± 3.89%) was produced by the one-presentation/s 44-region protocol. Across the four protocols, the effect of repeat testing was small (all methods ≤0.15 dB).

CONCLUSIONS:

Presentation rate had little effect, but increasing the tested density from 24 to 44 regions/field improved diagnostic power. Given that multifocal pupillographic objective perimetry also provides information on response delay and afferent versus efferent defects at every visual field region, it may be a useful adjunct to perimetry.

PMID:
23078067
DOI:
10.1111/ceo.12016
[Indexed for MEDLINE]

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