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WuDunn D, Takusagawa HL, Rosdahl JA, Sit AJ, Chopra V, Ou Y, Richter GM, Knight OJ, Solá-Del Valle D, Kim SJ. Central Visual Field Testing in Early Glaucoma: A Report by the American Academy of Ophthalmology. Ophthalmology 2024; 131:240-248. [PMID: 38069944 DOI: 10.1016/j.ophtha.2023.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 01/23/2024] Open
Abstract
PURPOSE To evaluate the current published literature on the utility of the 10-2 visual field (VF) testing strategy for the evaluation and management of early glaucoma, defined here as mean deviation (MD) better than -6 decibels (dB). METHODS A search of the peer-reviewed literature was last conducted in June 2023 in the PubMed database. Abstracts of 986 articles were examined to exclude reviews and non-English-language articles. After inclusion and exclusion criteria were applied, 26 articles were selected, and the panel methodologist rated them for strength of evidence. Thirteen articles were rated level I, and 8 articles were rated level II. The 5 level III articles were excluded. Data from the 21 included articles were abstracted and reviewed. RESULTS The central 12 locations on the 24-2 VF test grid lie within the central 10 degrees covered by the 10-2 VF test. In early glaucoma, defects detected within the central 10 degrees generally agree between the 2 tests. Defects within the central 10 degrees of the 24-2 VF test can predict defects on the 10-2 VF test, although the 24-2 may miss defects detected on the 10-2 VF test. In addition, results from the 10-2 VF test show better association with findings from OCT scans of the macular ganglion cell complex. Modifications of the 24-2 test that include extra test locations within the central 10 degrees improve detection of central defects found on 10-2 VF testing. CONCLUSIONS Evidence to date does not support routine testing using 10-2 VF for patients with early glaucoma. However, early 10-2 VF testing may provide sufficient additional information for some patients, particularly those with a repeatable defect within the central 12 locations of the standard 24-2 VF test or who have inner retinal layer thinning on OCT scans of the macula. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Darrell WuDunn
- University of Florida College of Medicine-Jacksonville, Department of Ophthalmology, Jacksonville, Florida
| | - Hana L Takusagawa
- VA Eugene Healthcare Center, Eugene, Oregon and Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon
| | - Jullia A Rosdahl
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Arthur J Sit
- Mayo Clinic, Department of Ophthalmology, Rochester, Minnesota
| | - Vikas Chopra
- Doheny Eye Centers UCLA and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Yvonne Ou
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | - Grace M Richter
- Department of Ophthalmology, Southern California Permanente Medical Group, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California; USC Roski Eye Institute, Keck Medicine of University of Southern California, Los Angeles, California
| | - O'Rese J Knight
- Department of Ophthalmology, University of California San Francisco, San Francisco, California
| | | | - Stephen J Kim
- Department of Ophthalmology, Vanderbilt University School of Medicine, Nashville, Tennessee
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Kim EK, Park HYL, Hong KE, Shin DY, Park CK. Investigation of progression pattern and associated risk factors in glaucoma patients with initial paracentral scotomas using Humphrey 10-2. Sci Rep 2021; 11:18609. [PMID: 34545112 PMCID: PMC8452676 DOI: 10.1038/s41598-021-97446-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Central visual field (VF) progression could directly threaten patientss visual function compared to glaucomatous damage. This study was designed to investigate visual field (VF) progression pattern and associated risk factors including optical coherence topography angiographic (OCT-A) findings in glaucoma patients with initial paracentral scotoma. This prospective, observational study included 122 eyes presenting as initial paracentral scotomas with serial 24-2 and 10-2 VF tests at the glaucoma clinic of Seoul St Mary's Hospital between November 2017 and August 2020. The participants underwent at least 5 serial VF exams and OCT-A at baseline. Numerical values of the initial and final 10-2 VF tests were averaged for each VF test point using the total deviation map. Innermost 10-2 VF progression was defined as three or more new contiguous points at the central 12 points on 10-2 VF. Other clinical characteristics were collected including history of disc hemorrhage and vessel density (VD) was measured from OCT-A images. Linear regression analysis was performed to obtain the change of mean deviation and a cut-off for progression was defined for both 24-2 and 10-2 VFs. The average total deviation maps of the initial 10-2 VF tests shows initial paracentral scotoma located in the superior region in an arcuate pattern that was deep in the 4°–6° region above fixation. This arcuate pattern was more broadly located in the 4°–10° region in the primary open-angle glaucoma (POAG) group, while it was closer to fixation in 0°–4° region in the normal-tension glaucoma (NTG) group. The final average map shows deepening of scotomas in the 4°–10° region in POAG, which deepened closer to the region of fixation in NTG. The diagnosis of NTG (β 1.892; 95% CI 1.225–2.516; P = 0.035) and lower choroidal VD in the peripapillary atrophy (PPA) region (β 0.985; 95% CI 0.975 to 0.995; P = 0.022) were significantly related to innermost 10-2 VF progression. Initial paracentral scotomas in NTG tended to progress closer to the region of fixation, which should be monitored closely. Important progression risk factors related to paracentral scotoma near the fixation were the diagnosis of NTG and reduced choroidal VD in the β-zone PPA region using OCT-A. We should consider vascular risk factors in NTG patients presenting with initial paracentral scotoma to avoid vision threatening progression of glaucoma.
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Affiliation(s)
- Eun Kyoung Kim
- Department of Ophthalmology, Seoul St. Mary's Hospital, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea.,College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea. .,College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Kyung Euy Hong
- Department of Ophthalmology, Seoul St. Mary's Hospital, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea.,College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Da Young Shin
- Department of Ophthalmology, Seoul St. Mary's Hospital, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea.,College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, 505 Banpo-dong, Seocho-ku, Seoul, 137-701, Korea.,College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Non-standard computer perimetry in the diagnosis of some optic neuropathies. OPHTHALMOLOGY JOURNAL 2021. [DOI: 10.17816/ov60059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Modern computer perimetry is divided into traditional white stimulus-on-white background, the gold standard of which is perimetry performed by using expert class perimeters Humphrey and Octopus and therefore called standard automatic or automated perimetry (SAP), and non-traditional or non-standard perimetry, which differs, first of all, in a different nature of a stimulus. The article is a review devoted to the assessment of the diagnostic capabilities of non-standard computer perimetry in the form of different variants of perimetry with doubling the spatial frequency (Frequency Doubling Technology Perimetry or FDT perimetry), which is performed by using perimeters of the 1st (Carl Zeiss Humphrey 710 Visual Field / FDT, 1997) and the 2nd (Carl Zeiss Humphrey Matrix / HM 715, 800 Visual Field Analyzer, 2005, 2010) generation. Most authors consider that FDT perimetry is effective in a glaucoma screening and, possibly, in monitoring a glaucomatous process, but only a few authors consider that non-standard perimetry method can be useful in diagnosing optic neuropathies of a different nature.
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Comparing isolated-check visual evoked potential, pattern visual evoked potential, and standard automated perimetry in dysthyroid optic neuropathy eyes. Eye (Lond) 2020; 35:2556-2563. [PMID: 33188292 PMCID: PMC8376950 DOI: 10.1038/s41433-020-01274-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/06/2020] [Accepted: 10/29/2020] [Indexed: 11/29/2022] Open
Abstract
Objective To determine the diagnostic ability of isolated-check visual evoked potential (icVEP), pattern visual evoked potential (pVEP), and standard automated perimetry (SAP) between dysthyroid optic neuropathy (DON) and thyroid-associated ophthalmopathy (TAO) without DON (non-DON). Methods This is a case-control study, 49 bilateral patients (26 DON and 23 non-DON) were included. icVEP, pVEP, and SAP were conducted in all the subjects, icVEP parameters compared were signal-to-noise ratios (SNRs) under 8, 16, and 32% depth of modulation (DOM). pVEP parameters compared were amplitude and latency. SAP parameters were mean deviation (MD) and pattern standard deviation (PSD). The area under the receiver operating characteristic (ROC) curve (AUC), net reclassification index (NRI), integrated discrimination index (IDI), and decision curve analysis (DCA) were applied for analysis. Results In icVEP, values of SNR in DON were significantly smaller than non-DON (p < 0.05). In pVEP, P100 latent time in DON was significantly larger than non-DON (p = 0.0026). In SAP, value of PSD in DON was larger than non-DON (p = 0.0006), and value of MD in DON was smaller (p = 0.0007). AUC, NRI, and IDI among the three tests were not significantly different. DCA showed that SNR of icVEP under 8% DOM was the farthest from the two extreme curves. Conclusions icVEP, pVEP, and SAP have equal diagnostic capabilities to discern between DON and non-DON. In addition, icVEP may represent a significant ancillary diagnostic approach to DON detection, with more clinical benefit.
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De Moraes CG, Paula JS, Blumberg DM, Cioffi GA, Al-Aswad LA, Girkin CA, Weinreb RN, Zangwill LM, Ritch R, Susanna R, Hood DC, Liebmann JM. Detection of Progression With 10-2 Standard Automated Perimetry: Development and Validation of an Event-Based Algorithm. Am J Ophthalmol 2020; 216:37-43. [PMID: 32278773 DOI: 10.1016/j.ajo.2020.03.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 03/21/2020] [Accepted: 03/31/2020] [Indexed: 11/17/2022]
Abstract
PURPOSE To describe the development of a new algorithm for detecting progressive changes in 10-2 visual field (VF) tests using event-based analysis and to test its validity in a second, independent glaucoma cohort. DESIGN Prospective cohort study. METHODS Patients with established open-angle glaucoma from the Macular Assessment and Progression Study (MAPS; development cohort, n = 151), and the African Descent and Glaucoma Evaluation Study (ADAGES; validation cohort, n = 52) were evaluated. The 10-2 VF results from MAPS were obtained during 4 test-retest sessions within a 4-month period. For the validation analysis, 10-2 VF results from ADAGES performed on at least 5 visits were used. The event-based pointwise changes on 10-2 tests in the validation cohort were determined using 2 progression criteria: at least 3 progressing VF locations on 2 or 3 consecutive tests ("possible" or "likely" progression). Linear mixed-effects models were used to evaluate VF progression. RESULTS In the validation cohort, the mean (SD) follow-up time was 2.3 (0.7) years. The number of eyes experiencing 10-2 VF progression based on "possible" and "likely" progression was 36 (54.5%) and 11 (16.6%), respectively. Eyes experiencing "possible" progression had MD changes (-0.60 dB/year [95% confidence interval (CI): -0.93 to -0.28]) faster than those not meeting this criterion (P < .001), whereas for those with "likely" progression the difference was -0.91 dB/year (95% CI: -1.26 to -0.56, P < .001). CONCLUSIONS A new event-based progression algorithm using the 10-2 VF can identify eyes experiencing more rapid MD progression and may be used as a tool to assess progressive macular functional changes in glaucoma.
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Affiliation(s)
- Carlos Gustavo De Moraes
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA; Department of Ophthalmology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
| | - Jayter Silva Paula
- Department of Ophthalmology, Otorhinolaryngology and Head Neck Surgery, Ribeirao Preto Medical School - University of Sao Paulo, Ribeirao Preto, Brazil
| | - Dana M Blumberg
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
| | - George A Cioffi
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
| | - Lama A Al-Aswad
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
| | - Christopher A Girkin
- Department of Ophthalmology, University of Alabama-Birmingham, Birmingham, Alabama, USA
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California-San Diego, San Diego, California, USA
| | - Linda M Zangwill
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California-San Diego, San Diego, California, USA
| | - Robert Ritch
- Einhorn Clinical Research Center, Department of Ophthalmology, New York Eye and Ear Infirmary of Mount Sinai, New York, New York, USA
| | - Remo Susanna
- Department of Ophthalmology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Donald C Hood
- Department of Psychology, Columbia University, New York, New York, USA
| | - Jeffrey M Liebmann
- Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Columbia University Medical Center, Edward S. Harkness Eye Institute, New York, New York, USA
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