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Robert N. Weinreb - One of the best experts on this subject based on the ideXlab platform.
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frequency doubling technology Perimetry for detection of the development of visual field defects in glaucoma suspect eyes a prospective study
JAMA Ophthalmology, 2014Co-Authors: Shu Liu, Robert N. Weinreb, Gilda Lai, Dennis S C Lam, Christopher Kaishun LeungAbstract:Importance While standard automated Perimetry (SAP) remains the reference standard for evaluation of visual field (VF) defects in glaucoma, this study demonstrates that frequency-doubling technology (FDT) Perimetry is effective in monitoring visual field progression and may detect the onset of visual field defects earlier than SAP. Objectives To compare detection of the development of VF defects, rate of change of VF loss, and risk factors for progression between SAP and matrix FDT Perimetry in glaucoma suspect and ocular hypertensive eyes. Design, Setting, and Participants A total of 113 glaucoma suspect and ocular hypertensive eyes from 76 patients with normal SAP and FDT Perimetry results at baseline were prospectively followed up for SAP and FDT Perimetry testing at approximately 4-month intervals for 30 months or longer. Patients were consecutively enrolled and followed up from January 2, 2008, to February 28, 2012, at the Hong Kong Eye Hospital, Chinese University of Hong Kong. Visual field progression was defined by the development of VF defects confirmed by 3 or more consecutive examinations at a cluster of 3 or more (less conservative) or 4 or more (more conservative) locations. The rates of change of mean deviation and pattern standard deviation were evaluated with linear mixed models and the risk factors for VF progression were computed with Cox proportional hazard models. Results During a median study period of 3.4 years, 8.0% of eyes developed VF defects detected by FDT Perimetry, 6.2% by SAP, and 4.4% by both using the less-conservative criteria. The detection dropped to 6.2%, 4.4%, and 2.7%, respectively, when the more-conservative criteria were applied. The rate of change of pattern standard deviation was significantly faster for FDT Perimetry than SAP ( P Conclusions and Relevance Frequency-doubling technology Perimetry would be useful to monitor the onset of VF defects in glaucoma and may detect VF defects not evident in SAP.
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comparison of standard automated Perimetry frequency doubling technology Perimetry and short wavelength automated Perimetry for detection of glaucoma
Investigative Ophthalmology & Visual Science, 2011Co-Authors: Shu Liu, Robert N. Weinreb, Shi Lam, Carol Y Cheung, Gilda Lai, Dennis S C Lam, Christopher Kaishun LeungAbstract:PURPOSE To compare the performance of standard automated Perimetry (SAP), frequency-doubling technology (FDT) Perimetry, and short-wavelength automated Perimetry (SWAP) in detecting glaucoma. METHODS One hundred thirty-two eyes of 95 glaucoma patients and 37 normal subjects had retinal nerve fiber layer (RNFL) imaging and visual field testing by SAP, Matrix FDT Perimetry, and Swedish interactive thresholding algorithm (SITA) SWAP at the same visit (all perimeters by Carl Zeiss Meditec, Inc., Dublin, CA). Visual field defects were confirmed with two or more consecutive examinations by the same types of Perimetry. Glaucoma was defined with the reference to the RNFL thickness deviation map score (≥ 4, glaucomatous; ≤ 2, normal). The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of MD (mean deviation) and PSD (pattern standard deviation) of the perimetries were compared. RESULTS Taking all glaucoma patients into consideration, the sensitivity was highest for Matrix FDT Perimetry (69%), followed by SAP (68%), and then SITA SWAP (59%). When the analysis included only patients with early glaucoma, the sensitivity decreased to 52%, 46%, and 34%, respectively, with a significant difference detected between Matrix FDT Perimetry and SITA SWAP (P = 0.034). The specificity was ≥ 97% for all perimetries. The AUCs of MD and PSD followed a similar order, with Matrix FDT Perimetry having the greatest AUC (0.89-0.94), followed by SAP (0.87-0.94), and then SITA SWAP (0.69-0.90). There were significant differences in sensitivities at 90% specificity between Matrix FDT Perimetry and SITA SWAP (P ≤ 0.005 for MD; P ≤ 0.039 for PSD). CONCLUSIONS The performance for glaucoma detection was comparable between FDT Perimetry and SAP. FDT Perimetry had a higher sensitivity for detecting glaucoma than did SWAP at a comparable level of specificity.
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Relationship of SITA and full-threshold standard Perimetry to frequency-doubling technology Perimetry in glaucoma.
Investigative Ophthalmology & Visual Science, 2005Co-Authors: Catherine Boden, Robert N. Weinreb, J.p. Pascual, Felipe A. Medeiros, Makoto Aihara, Pamela A. SampleAbstract:Purpose To compare full-threshold (FT) and SITA algorithms for standard automated Perimetry (SAP) with frequency-doubling technology Perimetry (FDT) in glaucoma, to help clinicians to relate results in patients who have had two or more of these tests during follow-up. Methods This study was a retrospective analysis of data from a longitudinal prospective study at the University of California, San Diego. One hundred four eyes of 104 patients with glaucomatous optic neuropathy detected by optic disc stereophotographs were included. All patients had standard Perimetry (SITA and FT) and FDT within 3 months of each other. Global indices, abnormality and severity using two threshold algorithms of standard Perimetry were compared with FDT. Results More eyes had normal visual fields by SAP-FT (57 eyes) than by either SAP-SITA (42 eyes) or FDT (45 eyes), although SAP-FT agreed more closely with FDT (kappa = 0.54 +/- 0.08) on the presence of a visual field defect than did SAP-SITA (kappa = 0.34 +/- 0.08). Correlations of FDT to standard Perimetry global indices were similar regardless of the threshold strategy used for standard Perimetry, yielding r2= 0.38-0.57 for SAP-FT with FDT, 0.36-0.54 for SAP-SITA with FDT. Conclusions Despite many similarities of SAP-SITA and SAP-FT, switching the standard of comparison from SAP-FT to SAP-SITA changes the relationship to FDT with regard to visual field abnormality, but not correlations of global indices. FDT detected abnormal fields in more eyes than SAP-FT. SAP-FT tended to detect a subset of eyes found abnormal by FDT. Visual field defects may be detected more often by FDT and SAP-SITA in eyes with early visual field loss, but these two tests may not agree on which eyes show field loss in patients who undergo both tests at follow-up.
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Relationship between visual field testing and scanning laser polarimetry in patients with a large cup-to-disk ratio
American Journal of Ophthalmology, 2001Co-Authors: Dana P Tannenbaum, Linda M. Zangwill, Christopher Bowd, Pamela A. Sample, Robert N. WeinrebAbstract:Abstract PURPOSE: To determine the relationship between quantitative nerve fiber layer measurements and visual field testing in patients with large cup-to-disk ratios. METHODS: Seventy-six patients with vertical cup-to-disk ratios by contour of at least 0.8 on stereoscopic photographs and 50 normal subjects were included. One eye was randomly selected for study. All patients underwent standard achromatic automated Perimetry, short-wavelength automated Perimetry, and retinal nerve fiber layer measurements with scanning laser polarimetry. Analysis of variance was used to evaluate differences between the subject groups. Significance of pairwise comparisons was determined using the Tukey–Kramer multiple comparison test. RESULTS: Statistically significant differences in nerve fiber layer measurements between patients with large cup-to-disk ratios and both abnormal standard achromatic automated Perimetry and short-wavelength automated Perimetry (n = 22) and patients with large cup-to-disk ratios and both normal standard achromatic automated Perimetry and short-wavelength automated Perimetry (n = 42) were found for superior nasal ratio, maximum modulation, ellipse modulation, and the linear discriminant function (Tukey–Kramer less than .05). There was no significant difference in patients with abnormal short-wavelength automated Perimetry only (n = 9) as compared with patients with both normal standard achromatic automated Perimetry and short-wavelength automated Perimetry and patients with both abnormal standard achromatic automated Perimetry and short-wavelength automated Perimetry. Statistically significant differences between the normal subjects and patients with large cup-to-disk ratios and both abnormal standard achromatic automated Perimetry and short-wavelength automated Perimetry were found for all retinal nerve fiber layer parameters, with the exception of symmetry, superior ratio, and inferior ratio. CONCLUSION: Our results show considerable overlap in nerve fiber layer measurements in eyes with large cup-to-disk ratio and abnormal visual fields as compared with eyes with large cup-to-disk ratios and normal visual fields. This may limit the clinical usefulness of scanning laser polarimetry for detection of early glaucoma in patients with large cup-to-disk ratios. Longitudinal studies are needed to determine if patients with large cup-to-disk ratios with normal standard achromatic automated Perimetry and abnormal short-wavelength automated Perimetry subsequently develop standard achromatic automated Perimetry defects and if scanning laser polarimetry can concurrently detect progression of nerve fiber layer damage.
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Short-wavelength automated Perimetry and standard Perimetry in the detection of progressive optic disc cupping.
Archives of Ophthalmology, 2000Co-Authors: Christopher A. Girkin, Linda M. Zangwill, Pamela A. Sample, Alireza Emdadi, Eytan Z. Blumenthal, Alexander C Lee, Robert N. WeinrebAbstract:Objective To compare progression in short-wavelength automated Perimetry (SWAP) and white-on-white (standard) Perimetry in eyes with progressive glaucomatous changes of the optic disc detected by serial stereophotographs. Methods Forty-seven glaucoma patients with at least 2 disc stereophotographs more than 2 years apart, along with standard Perimetry and SWAP examinations within 6 months of each disc photo of the same eye, were included in the study. The mean follow-up time was 4.1 years (range, 2.0-8.9 years). Baseline and follow-up stereophotographs were then graded and compared for the presence of progression. Progression in standard Perimetry and SWAP, using the Advanced Glaucoma Intervention Study scoring system and a clinical scoring system, was compared between eyes with progressive change on stereophotographs and those without. Results Twenty-two of 47 eyes showed progressive change by stereophotographs. There was a statistically significant difference in the mean change in Advanced Glaucoma Intervention Study scores for both standard Perimetry ( P P P = .04). Conclusions Short-wavelength automated Perimetry identified more patients than standard Perimetry as having progressive glaucomatous changes of the optic disc. Compared with standard Perimetry, SWAP may improve the detection of progressive glaucoma.
Pamela A. Sample - One of the best experts on this subject based on the ideXlab platform.
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Relationship of SITA and full-threshold standard Perimetry to frequency-doubling technology Perimetry in glaucoma.
Investigative Ophthalmology & Visual Science, 2005Co-Authors: Catherine Boden, Robert N. Weinreb, J.p. Pascual, Felipe A. Medeiros, Makoto Aihara, Pamela A. SampleAbstract:Purpose To compare full-threshold (FT) and SITA algorithms for standard automated Perimetry (SAP) with frequency-doubling technology Perimetry (FDT) in glaucoma, to help clinicians to relate results in patients who have had two or more of these tests during follow-up. Methods This study was a retrospective analysis of data from a longitudinal prospective study at the University of California, San Diego. One hundred four eyes of 104 patients with glaucomatous optic neuropathy detected by optic disc stereophotographs were included. All patients had standard Perimetry (SITA and FT) and FDT within 3 months of each other. Global indices, abnormality and severity using two threshold algorithms of standard Perimetry were compared with FDT. Results More eyes had normal visual fields by SAP-FT (57 eyes) than by either SAP-SITA (42 eyes) or FDT (45 eyes), although SAP-FT agreed more closely with FDT (kappa = 0.54 +/- 0.08) on the presence of a visual field defect than did SAP-SITA (kappa = 0.34 +/- 0.08). Correlations of FDT to standard Perimetry global indices were similar regardless of the threshold strategy used for standard Perimetry, yielding r2= 0.38-0.57 for SAP-FT with FDT, 0.36-0.54 for SAP-SITA with FDT. Conclusions Despite many similarities of SAP-SITA and SAP-FT, switching the standard of comparison from SAP-FT to SAP-SITA changes the relationship to FDT with regard to visual field abnormality, but not correlations of global indices. FDT detected abnormal fields in more eyes than SAP-FT. SAP-FT tended to detect a subset of eyes found abnormal by FDT. Visual field defects may be detected more often by FDT and SAP-SITA in eyes with early visual field loss, but these two tests may not agree on which eyes show field loss in patients who undergo both tests at follow-up.
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Relationship between visual field testing and scanning laser polarimetry in patients with a large cup-to-disk ratio
American Journal of Ophthalmology, 2001Co-Authors: Dana P Tannenbaum, Linda M. Zangwill, Christopher Bowd, Pamela A. Sample, Robert N. WeinrebAbstract:Abstract PURPOSE: To determine the relationship between quantitative nerve fiber layer measurements and visual field testing in patients with large cup-to-disk ratios. METHODS: Seventy-six patients with vertical cup-to-disk ratios by contour of at least 0.8 on stereoscopic photographs and 50 normal subjects were included. One eye was randomly selected for study. All patients underwent standard achromatic automated Perimetry, short-wavelength automated Perimetry, and retinal nerve fiber layer measurements with scanning laser polarimetry. Analysis of variance was used to evaluate differences between the subject groups. Significance of pairwise comparisons was determined using the Tukey–Kramer multiple comparison test. RESULTS: Statistically significant differences in nerve fiber layer measurements between patients with large cup-to-disk ratios and both abnormal standard achromatic automated Perimetry and short-wavelength automated Perimetry (n = 22) and patients with large cup-to-disk ratios and both normal standard achromatic automated Perimetry and short-wavelength automated Perimetry (n = 42) were found for superior nasal ratio, maximum modulation, ellipse modulation, and the linear discriminant function (Tukey–Kramer less than .05). There was no significant difference in patients with abnormal short-wavelength automated Perimetry only (n = 9) as compared with patients with both normal standard achromatic automated Perimetry and short-wavelength automated Perimetry and patients with both abnormal standard achromatic automated Perimetry and short-wavelength automated Perimetry. Statistically significant differences between the normal subjects and patients with large cup-to-disk ratios and both abnormal standard achromatic automated Perimetry and short-wavelength automated Perimetry were found for all retinal nerve fiber layer parameters, with the exception of symmetry, superior ratio, and inferior ratio. CONCLUSION: Our results show considerable overlap in nerve fiber layer measurements in eyes with large cup-to-disk ratio and abnormal visual fields as compared with eyes with large cup-to-disk ratios and normal visual fields. This may limit the clinical usefulness of scanning laser polarimetry for detection of early glaucoma in patients with large cup-to-disk ratios. Longitudinal studies are needed to determine if patients with large cup-to-disk ratios with normal standard achromatic automated Perimetry and abnormal short-wavelength automated Perimetry subsequently develop standard achromatic automated Perimetry defects and if scanning laser polarimetry can concurrently detect progression of nerve fiber layer damage.
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Short-wavelength automated Perimetry and standard Perimetry in the detection of progressive optic disc cupping.
Archives of Ophthalmology, 2000Co-Authors: Christopher A. Girkin, Linda M. Zangwill, Pamela A. Sample, Alireza Emdadi, Eytan Z. Blumenthal, Alexander C Lee, Robert N. WeinrebAbstract:Objective To compare progression in short-wavelength automated Perimetry (SWAP) and white-on-white (standard) Perimetry in eyes with progressive glaucomatous changes of the optic disc detected by serial stereophotographs. Methods Forty-seven glaucoma patients with at least 2 disc stereophotographs more than 2 years apart, along with standard Perimetry and SWAP examinations within 6 months of each disc photo of the same eye, were included in the study. The mean follow-up time was 4.1 years (range, 2.0-8.9 years). Baseline and follow-up stereophotographs were then graded and compared for the presence of progression. Progression in standard Perimetry and SWAP, using the Advanced Glaucoma Intervention Study scoring system and a clinical scoring system, was compared between eyes with progressive change on stereophotographs and those without. Results Twenty-two of 47 eyes showed progressive change by stereophotographs. There was a statistically significant difference in the mean change in Advanced Glaucoma Intervention Study scores for both standard Perimetry ( P P P = .04). Conclusions Short-wavelength automated Perimetry identified more patients than standard Perimetry as having progressive glaucomatous changes of the optic disc. Compared with standard Perimetry, SWAP may improve the detection of progressive glaucoma.
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visual function specific Perimetry for indirect comparison of different ganglion cell populations in glaucoma
Investigative Ophthalmology & Visual Science, 2000Co-Authors: Pamela A. Sample, Christopher A. Girkin, Eytan Z. Blumenthal, Charles F Bosworth, Robert N. WeinrebAbstract:PURPOSE To compare short-wavelength automated Perimetry, frequency-doubling technology Perimetry, and motion-automated Perimetry, each of which assesses different aspects of visual function, in eyes with glaucomatous optic neuropathy and ocular hypertension. METHODS One hundred thirty-six eyes from 136 subjects were evaluated with all three tests as well as with standard automated Perimetry. Fields were not used in the classification of study groups to prevent bias, because the major purpose of the study was to evaluate each field type relative to the others. Seventy-one of the 136 eyes had glaucomatous optic neuropathy, 37 had ocular hypertension, and 28 served as age-matched normal control eyes. Glaucomatous optic neuropathy was defined by assessment of stereophotographs. Criteria were asymmetrical cupping, the presence of rim thinning, notching, excavation, or nerve fiber layer defect. Ocular hypertensive eyes had intraocular pressure of 23 mm Hg or more on at least two occasions and normal-appearing optic disc stereophotographs. Criteria for abnormality on each visual field test were selected to approximate a specificity of 90% in the normal eyes. Thresholds for each of the four tests were compared, to determine the percentage that were abnormal within each patient group and to assess the agreement among test results for abnormality, location, and extent of visual field deficit. RESULTS Each test identified a subset of the eyes with glaucomatous optic neuropathy as abnormal: 46% with standard Perimetry, 61% with short-wavelength automated Perimetry, 70% with frequency-doubling Perimetry, and 52% with motion-automated Perimetry. In the ocular hypertensive eyes, standard Perimetry was abnormal in 5%, short wavelength in 22%, frequency doubling in 46%, and motion in 30%. Fifty-four percent (38/71) of eyes with glaucomatous optic neuropathy were normal on standard fields. However, 90% were identified by at least one of the specific visual function tests. Combining tests improved sensitivity with slight reductions in specificity. The agreement in at least one quadrant, when a defect was present with more than one test, was very high at 92% to 97%. More extensive deficits were shown by frequency-doubling Perimetry followed by short-wavelength automated Perimetry, then motion-automated Perimetry, and last, standard Perimetry. However, there were significant individual differences in which test of any given pairing was more extensively affected. Only 30% (11/37) of the ocular hypertensive eyes showed no deficits at all compared with 71% (20/28) of the control eyes (P < 0.001). CONCLUSIONS For detection of functional loss standard visual field testing is not optimum; a combination of two or more tests may improve detection of functional loss in these eyes; in an individual, the same retinal location is damaged, regardless of visual function under test; glaucomatous optic neuropathy identified on stereophotographs may precede currently measurable function loss in some eyes; conversely, function loss with specific tests may precede detection of abnormality by stereophotograph review; and short-wavelength automated Perimetry, frequency-doubling Perimetry, and motion-automated Perimetry continue to show promise as early indicators of function loss in glaucoma.
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Short-Wavelength Automated Perimetry and Motion Automated Perimetry in Patients With Glaucoma
Archives of Ophthalmology, 1997Co-Authors: Pamela A. Sample, Charles F Bosworth, Robert N. WeinrebAbstract:Objective: To compare short-wavelength automated Perimetry (SWAP), a test favoring the detection of the target by the parvocellular pathways of vision, with motion automated Perimetry (MAP), a test favoring detection by the magnocellular pathways, in the same eyes. Participants: Thirty-three individuals in whom glaucoma was suspected (glaucoma suspects) and 17 patients with primary open-angle glaucoma were compared with 30 age-matched normal control subjects. Interventions: Short-wavelength automated Perimetry was done with the usual protocol (program 24-2). Motion coherence thresholds were measured with 14 random dot targets that covered the 24-2 field area. Short-wavelength automated Perimetry test locations corresponding to each of the 14 motion automated Perimetry locations were averaged to compare 14 locations for each test. Results: Short-wavelength automated Perimetry and motion automated Perimetry were correlated by visual field location (whole field r =-0.40, P r =−0.45, P P Conclusions: Both tests successfully identified eyes with glaucoma and a percentage of the glaucoma suspect eyes; both were correlated by field location. These results suggest that damage due to glaucoma is nonselective for either the parvocellular or the magnocellular ganglion cell axons, that there may be individual differences in which type of ganglion cell shows damage first, and that when standard visual field loss is present the results of SWAP and MAP are defective.
Chris A Johnson - One of the best experts on this subject based on the ideXlab platform.
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variability components of standard automated Perimetry and frequency doubling technology Perimetry
Investigative Ophthalmology & Visual Science, 2001Co-Authors: Paul G D Spry, Allison M. Mckendrick, Chris A Johnson, Andrew TurpinAbstract:PURPOSE. To evaluate and compare intra- and intertest variability components for both standard automated Perimetry (SAP) and frequency-doubling technology (FDT) Perimetry in a small group of normal individuals and patients with glaucoma. METHODS. The method of constant stimuli (MOCS) was used to examine matched test locations with both SAP and FDT Perimetry stimuli in a group of eight normal individuals and seven patients with glaucoma. Subjects were tested weekly at three predetermined visual field loci for 5 consecutive weeks. Frequency-of-seeing (FOS) curves were generated and used to quantify threshold sensitivity (50% seen on FOS, in decibels), intratest variability (FOS interquartile range, in decibels), and intertest variability (interquartile range of weekly repeated threshold determinations, in decibels). RESULTS. In patients with glaucoma, SAP intra- and intertest variabilities were found to increase with sensitivity reductions, as previously reported. FDT Perimetry revealed that both intraand intertest variability components did not appreciably change with reductions in sensitivity. With the measurement scales used in this investigation, both intra- and intertest variability components were significantly greater for SAP than for FDT Perimetry (P , 0.001 and P 5 0.003, respectively). Intratest variability exceeded intertest variability for both SAP (P 5 0.001) and FDT Perimetry (P , 0.001). CONCLUSIONS. For both SAP and FDT Perimetry, variability occurring within a single test session contributed more to total variability than between-session variability. When the measurement scales available on commercial instrumentation were used, FDT Perimetry exhibited significantly less variability than SAP, especially within regions of visual field sensitivity loss. FDT Perimetry therefore shows promise as an effective test for detecting progressive glaucomatous visual field loss, although prospective longitudinal validation is still required to determine sensitivity to change. (Invest Ophthalmol Vis Sci. 2001; 42:1404 ‐1410)
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Test-retest variability of frequency-doubling Perimetry and conventional Perimetry in glaucoma patients and normal subjects
Investigative Ophthalmology & Visual Science, 1999Co-Authors: Balwantray C. Chauhan, Chris A JohnsonAbstract:PURPOSE. To compare the test-retest variability characteristics of frequency-doubling Perimetry, a new perimetric test, with those of conventional Perimetry in glaucoma patients and normal control subjects. METHODS. The study sample contained 64 patients and 47 normal subjects aged 66.16 ± 11.86 and 64.26 ± 7.99 years (mean ± SD), respectively. All subjects underwent frequency-doubling Perimetry (using the threshold mode) and conventional Perimetry (using program 30-2 of the Humphrey Field Analyzer: Humphrey Instruments, San Leandro, CA) in one randomly selected eye. Each test was repeated at 1-week intervals for five tests with each technique over 4 weeks. Empirical 5th and 95th percentiles of the distribution of threshold deviations at retest were determined for all combinations of single tests and mean of two tests, stratified by threshold deviation. The influence of visual field eccentricity and overall visual field loss on variability also were examined. RESULTS. Mean test time with frequency-doubling Perimetry in patients and normal control subjects was 5.90 and 5.25 minutes, respectively, and with conventional Perimetry was 17.20 and 14.01 minutes, respectively. In patients, there was a significant correlation between the results of the two techniques, in the full field and in quadrants, whereas in normal subjects there was no such correlation. In patients, the retest variability of conventional Perimetry in locations with 20-dB loss was 120% (single tests) and 127% (mean tests) higher compared with that in locations with 0-dB loss. Comparative figures for frequency-doubling Perimetry were 40% and 47%, respectively. Variability also increased more with threshold deviation in normal subjects tested with conventional Perimetry. In both patients and normal subjects, variability increased with visual field eccentricity in conventional Perimetry, but not in frequency-doubling Perimetry. Both techniques showed an increase in variability with overall visual field damage. CONCLUSIONS. Frequency-doubling Perimetry has different test-retest variability characteristics than conventional Perimetry and may have potential for monitoring glaucomatous field damage.
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Longitudinal comparison of temporal-modulation Perimetry with white-on-white and blue-on-yellow Perimetry in ocular hypertension and early glaucoma.
Journal of The Optical Society of America A-optics Image Science and Vision, 1993Co-Authors: Evanne J Casson, Chris A Johnson, Lionel R. ShapiroAbstract:We obtained data over 3 years on temporal-modulation Perimetry (TMP), standard automated [white-on-white (W/W)] Perimetry, and short-wavelength-sensitive [blue-on-yellow (B/Y)] Perimetry in ocular hypertensive (OH) patients and patients with early glaucomatous visual-field loss (EG). Evidence of visual-field defects was obtained with the use of both B/Y Perimetry and TMP in the majority of OH and EQ eyes that demonstrated progression on W/W Perimetry as well as in all stable EG eyes. Using the nerve-fiber-bundle pattern to compare testing procedures, we determined that these defects were generally as extensive or more extensive than the concurrent W/W abnormalities. In terms of location over the 3 years of testing, TMP and B/Y defects were reasonably consistent in the EG eyes, somewhat less consistent in the OH eyes demonstrating progression, and both inconsistent and infrequent in the stable OH eyes. The greatest degree of overlap occurred between the location of defects obtained by use of the higher TMP frequencies (8 and 16 Hz) and that of defects obtained by use of B/Y Perimetry. Since these two methods are thought to isolate different visual mechanisms subserved by different visual pathways, these results suggest that early glaucomatous visual-field damage as revealed by TMP and B/Y Perimetry may not be specific to a single visual pathway.
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progression of early glaucomatous visual field loss as detected by blue on yellow and standard white on white automated Perimetry
Archives of Ophthalmology, 1993Co-Authors: Chris A Johnson, Anthony J Adams, Evanne J Casson, James D BrandtAbstract:• Objective. —To determine whether blue-on-yellow Perimetry reveals progression of glaucomatous damage before it is evident with standard white-on-white Perimetry. Design. —A Humphrey field analyzer (Humphrey Instruments, San Leandro, Calif) was modified to perform blue-on-yellow Perimetry to isolate and measure the sensitivity of short wavelength-sensitive mechanisms. Participants were tested annually with standard white-on-white automated Perimetry and blue-on-yellow automated Perimetry for 5 years. Patients. —Sixteen patients with early glaucomatous visual field loss in one or both eyes and 62 age-matched normal control subjects. Results. —At baseline, 25 (78.1%) of the 32 eyes exhibited larger deficits with blue-on-yellow Perimetry, five (15.6%) had equivalent loss with both tests, and two (6.3%) had larger deficits with standard white-on-white Perimetry. Seven (21.9%) of the 32 eyes demonstrated evidence of progressive visual field loss with standard white-on-white Perimetry in 5 years, while the other 25 eyes (78.1%) were relatively stable. Deficits with blue-on-yellow Perimetry were twice as large as deficits with white-on-white Perimetry in the stable group and were three to four times as large in the group with progressive field loss. Conclusions. —Blue-on-yellow Perimetry is effective in predicting which patients with early glaucomatous visual field loss are most likely to have progressive loss. The rate of progressive loss is greater with blue-on-yellow Perimetry than with standard white-on-white Perimetry.
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blue on yellow Perimetry can predict the development of glaucomatous visual field loss
Archives of Ophthalmology, 1993Co-Authors: Chris A Johnson, Anthony J Adams, Evanne J Casson, James D BrandtAbstract:• Objective. —The purpose of this investigation was to determine whether blue-on-yellow (B/Y) Perimetry is capable of predicting the onset and location of impending glaucomatous visual field loss in patients with ocular hypertension. Design. —A Humphrey Field Analyzer (Humphrey Instruments, San Leandro, Calif) was modified to perform B/Y Perimetry to isolate and measure the sensitivity of short-wavelength—sensitive mechanisms. Participants were tested annually with standard white-on-white (W/W) and B/Y automated Perimetry for a period of 5 years. Patients. —The study population consisted of 38 patients with ocular hypertension and 62 age-matched normal control subjects. Results. —Initially, all 76 ocular hypertensive eyes had normal W/W automated Perimetry results, with 67 eyes having normal and nine eyes having abnormal B/Y test results. Five years later, five of the nine ocular hypertensive eyes with initial B/Y abnormal results developed glaucomatous visual field loss measured by standard W/W automated Perimetry, while none of the 67 ocular hypertensive eyes with initially normal B/Y results developed abnormal W/W Perimetry results. Conclusions. —Blue-on-yellow Perimetry deficits are an early indicator of glaucomatous damage and are predictive of impending glaucomatous visual field loss for standard W/W automated Perimetry. To our knowledge, this is the first prospective, long-term longitudinal study that demonstrates the ability to predict the onset of glaucomatous visual field loss in patients with ocular hypertension on the basis of psychophysical testing.
James D Brandt - One of the best experts on this subject based on the ideXlab platform.
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progression of early glaucomatous visual field loss as detected by blue on yellow and standard white on white automated Perimetry
Archives of Ophthalmology, 1993Co-Authors: Chris A Johnson, Anthony J Adams, Evanne J Casson, James D BrandtAbstract:• Objective. —To determine whether blue-on-yellow Perimetry reveals progression of glaucomatous damage before it is evident with standard white-on-white Perimetry. Design. —A Humphrey field analyzer (Humphrey Instruments, San Leandro, Calif) was modified to perform blue-on-yellow Perimetry to isolate and measure the sensitivity of short wavelength-sensitive mechanisms. Participants were tested annually with standard white-on-white automated Perimetry and blue-on-yellow automated Perimetry for 5 years. Patients. —Sixteen patients with early glaucomatous visual field loss in one or both eyes and 62 age-matched normal control subjects. Results. —At baseline, 25 (78.1%) of the 32 eyes exhibited larger deficits with blue-on-yellow Perimetry, five (15.6%) had equivalent loss with both tests, and two (6.3%) had larger deficits with standard white-on-white Perimetry. Seven (21.9%) of the 32 eyes demonstrated evidence of progressive visual field loss with standard white-on-white Perimetry in 5 years, while the other 25 eyes (78.1%) were relatively stable. Deficits with blue-on-yellow Perimetry were twice as large as deficits with white-on-white Perimetry in the stable group and were three to four times as large in the group with progressive field loss. Conclusions. —Blue-on-yellow Perimetry is effective in predicting which patients with early glaucomatous visual field loss are most likely to have progressive loss. The rate of progressive loss is greater with blue-on-yellow Perimetry than with standard white-on-white Perimetry.
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blue on yellow Perimetry can predict the development of glaucomatous visual field loss
Archives of Ophthalmology, 1993Co-Authors: Chris A Johnson, Anthony J Adams, Evanne J Casson, James D BrandtAbstract:• Objective. —The purpose of this investigation was to determine whether blue-on-yellow (B/Y) Perimetry is capable of predicting the onset and location of impending glaucomatous visual field loss in patients with ocular hypertension. Design. —A Humphrey Field Analyzer (Humphrey Instruments, San Leandro, Calif) was modified to perform B/Y Perimetry to isolate and measure the sensitivity of short-wavelength—sensitive mechanisms. Participants were tested annually with standard white-on-white (W/W) and B/Y automated Perimetry for a period of 5 years. Patients. —The study population consisted of 38 patients with ocular hypertension and 62 age-matched normal control subjects. Results. —Initially, all 76 ocular hypertensive eyes had normal W/W automated Perimetry results, with 67 eyes having normal and nine eyes having abnormal B/Y test results. Five years later, five of the nine ocular hypertensive eyes with initial B/Y abnormal results developed glaucomatous visual field loss measured by standard W/W automated Perimetry, while none of the 67 ocular hypertensive eyes with initially normal B/Y results developed abnormal W/W Perimetry results. Conclusions. —Blue-on-yellow Perimetry deficits are an early indicator of glaucomatous damage and are predictive of impending glaucomatous visual field loss for standard W/W automated Perimetry. To our knowledge, this is the first prospective, long-term longitudinal study that demonstrates the ability to predict the onset of glaucomatous visual field loss in patients with ocular hypertension on the basis of psychophysical testing.
Christopher Kaishun Leung - One of the best experts on this subject based on the ideXlab platform.
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frequency doubling technology Perimetry for detection of the development of visual field defects in glaucoma suspect eyes a prospective study
JAMA Ophthalmology, 2014Co-Authors: Shu Liu, Robert N. Weinreb, Gilda Lai, Dennis S C Lam, Christopher Kaishun LeungAbstract:Importance While standard automated Perimetry (SAP) remains the reference standard for evaluation of visual field (VF) defects in glaucoma, this study demonstrates that frequency-doubling technology (FDT) Perimetry is effective in monitoring visual field progression and may detect the onset of visual field defects earlier than SAP. Objectives To compare detection of the development of VF defects, rate of change of VF loss, and risk factors for progression between SAP and matrix FDT Perimetry in glaucoma suspect and ocular hypertensive eyes. Design, Setting, and Participants A total of 113 glaucoma suspect and ocular hypertensive eyes from 76 patients with normal SAP and FDT Perimetry results at baseline were prospectively followed up for SAP and FDT Perimetry testing at approximately 4-month intervals for 30 months or longer. Patients were consecutively enrolled and followed up from January 2, 2008, to February 28, 2012, at the Hong Kong Eye Hospital, Chinese University of Hong Kong. Visual field progression was defined by the development of VF defects confirmed by 3 or more consecutive examinations at a cluster of 3 or more (less conservative) or 4 or more (more conservative) locations. The rates of change of mean deviation and pattern standard deviation were evaluated with linear mixed models and the risk factors for VF progression were computed with Cox proportional hazard models. Results During a median study period of 3.4 years, 8.0% of eyes developed VF defects detected by FDT Perimetry, 6.2% by SAP, and 4.4% by both using the less-conservative criteria. The detection dropped to 6.2%, 4.4%, and 2.7%, respectively, when the more-conservative criteria were applied. The rate of change of pattern standard deviation was significantly faster for FDT Perimetry than SAP ( P Conclusions and Relevance Frequency-doubling technology Perimetry would be useful to monitor the onset of VF defects in glaucoma and may detect VF defects not evident in SAP.
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comparison of standard automated Perimetry frequency doubling technology Perimetry and short wavelength automated Perimetry for detection of glaucoma
Investigative Ophthalmology & Visual Science, 2011Co-Authors: Shu Liu, Robert N. Weinreb, Shi Lam, Carol Y Cheung, Gilda Lai, Dennis S C Lam, Christopher Kaishun LeungAbstract:PURPOSE To compare the performance of standard automated Perimetry (SAP), frequency-doubling technology (FDT) Perimetry, and short-wavelength automated Perimetry (SWAP) in detecting glaucoma. METHODS One hundred thirty-two eyes of 95 glaucoma patients and 37 normal subjects had retinal nerve fiber layer (RNFL) imaging and visual field testing by SAP, Matrix FDT Perimetry, and Swedish interactive thresholding algorithm (SITA) SWAP at the same visit (all perimeters by Carl Zeiss Meditec, Inc., Dublin, CA). Visual field defects were confirmed with two or more consecutive examinations by the same types of Perimetry. Glaucoma was defined with the reference to the RNFL thickness deviation map score (≥ 4, glaucomatous; ≤ 2, normal). The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of MD (mean deviation) and PSD (pattern standard deviation) of the perimetries were compared. RESULTS Taking all glaucoma patients into consideration, the sensitivity was highest for Matrix FDT Perimetry (69%), followed by SAP (68%), and then SITA SWAP (59%). When the analysis included only patients with early glaucoma, the sensitivity decreased to 52%, 46%, and 34%, respectively, with a significant difference detected between Matrix FDT Perimetry and SITA SWAP (P = 0.034). The specificity was ≥ 97% for all perimetries. The AUCs of MD and PSD followed a similar order, with Matrix FDT Perimetry having the greatest AUC (0.89-0.94), followed by SAP (0.87-0.94), and then SITA SWAP (0.69-0.90). There were significant differences in sensitivities at 90% specificity between Matrix FDT Perimetry and SITA SWAP (P ≤ 0.005 for MD; P ≤ 0.039 for PSD). CONCLUSIONS The performance for glaucoma detection was comparable between FDT Perimetry and SAP. FDT Perimetry had a higher sensitivity for detecting glaucoma than did SWAP at a comparable level of specificity.
