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Differences in Static and Kinetic Perimetry Results are Eliminated in Retinal Disease when Psychophysical Procedures are Equated
摘要： Purpose: We tested the hypothesis that clinical statokinetic dissociation (SKD, defined as the difference in sensitivity to static and kinetic stimuli) at the scotoma border in retinal disease is due to individual criterion bias and that SKD can be eliminated by equating the psychophysical procedures for testing static and kinetic stimulus detection. Methods: Six subjects with glaucoma and six with retinitis pigmentosa (RP) were tested. Clinical procedures (standard automated perimetry [SAP] and manual kinetic perimetry [MKP]) were used to determine clinical SKD and the region of interest for laboratory-based testing. Two-way Method of Limits (MoL) was used to establish the isocontrast region at the scotoma border in glaucoma and RP subjects. Method of Constant Stimuli (MoCS) and a two-interval forced choice (2IFC) procedure then were used to present static or kinetic (inward or outward) stimuli at different eccentricities within the isocontrast region. The results were fitted with psychometric functions to determine threshold eccentricities. Results: Clinical SKD was found in glaucoma and RP subjects, with variable magnitude among subjects, but significantly exceeding expected typical measurement variability. The resultant psychometric functions when using MoCS and 2IFC showed equal sensitivity to static and kinetic targets, thus eliminating SKD. Conclusions: Clinical SKD found using clinical techniques is due to methodologic differences and criterion bias, and is eliminated by using an equated and more objective psychophysical task, similar to normal subjects. Translational relevance: Eliminating SKD using a psychophysical approach minimizing criterion bias suggests that it is not useful to distinguish between normal and diseased fields.
关键词： glaucoma,retinitis pigmentosa,standard automated perimetry,statokinetic dissociation,Goldmann perimetry
更新于2025-09-23 15:22:29
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Evaluation of Structure-Function Relationships in Longitudinal Changes of Glaucoma using the Spectralis OCT Follow-Up Mode
摘要： The detection of glaucoma progression is an essential part of glaucoma management. Subjectivity of standard automated perimetry (SAP) prevents the accurate evaluation of progression, thus the detection of structural changes by optical coherence tomography (OCT) is attracting attention. Despite its objectivity, there is controversy about the appropriateness of the use of OCT, because many previous studies have indicated OCT results may not reflect the deterioration of visual field. A reason for this dissociation may be the test-retest variability of OCT, a major cause of which is misplacement of the measurement location. Recent advantages of spectral-domain OCT (SD-OCT), especially Spectralis OCT with an eye-tracking system (follow-up mode) enable measurement at approximately the same location as previous examinations. In addition to utilizing Spectralis follow-up mode, we introduced structure-function relationship map and nonlinear relationship between SAP and OCT results in considering structure-function relationship in longitudinal changes. The introduction of these two ideas in our study population improved the correlation between the SAP and OCT (R = 0.589 at most). The results of this study support the practical use of OCT in glaucoma progression but also stress the importance of focus on the corresponding focal changes and the consideration of disease severity.
关键词： longitudinal study,standard automated perimetry,optical coherence tomography,structure-function relationship,glaucoma progression
更新于2025-09-10 09:29:36
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Variability in monocular and binocular fixation during standard automated perimetry
摘要： The aim of this cross-sectional study was to use standard automated perimetry to compare fixation variability among the dominant eye fixation, non-dominant eye fixation, and binocular fixation conditions. Thirty-five eyes of 35 healthy young participants underwent standard automated perimetry (Humphrey 24–2 SITA-Standard) in dominant eye fixation, non-dominant eye fixation, and binocular fixation conditions. Fixation variability during foveal threshold and visual field measurement, which was recorded using a wearable eye-tracking glass and calculated using the bivariate contour ellipse area (deg2), was compared among the three fixation conditions. Further, the association of bivariate contour ellipse area with ocular position and fusional amplitude during binocular fixation was analysed. There were no significant differences in bivariate contour ellipse area during foveal threshold measurement among the dominant eye fixation (1.75 deg2), non-dominant eye fixation (1.45 deg2), and binocular fixation (1.62 deg2) conditions. In contrast, the bivariate contour ellipse area during visual field measurement in binocular fixation (2.85 deg2) was significantly lower than the bivariate contour ellipse area in dominant eye fixation (4.62 deg2; p = 0.0227) and non-dominant eye fixation (5.24 deg2; p = 0.0006) conditions. There was no significant difference in bivariate contour ellipse area during visual field measurement between dominant eye fixation and non-dominant eye fixation conditions. There was no significant correlation between bivariate contour ellipse area and either ocular position or fusional amplitude during both foveal threshold and visual field measurements. Thus, fixation variability might be improved in binocular fixation conditions during a long-duration test, such as visual field measurement.
关键词： binocular fixation,standard automated perimetry,monocular fixation,fixation variability,bivariate contour ellipse area
更新于2025-09-09 09:28:46
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Frequency-doubling technology perimetry and multifocal visual evoked potential in glaucoma, suspected glaucoma, and control patients
摘要： The gold standard in functional glaucoma evaluation is standard automated perimetry (SAP). However, SAP depends on the reliability of the patients’ responses and other external factors; therefore, other technologies have been developed for earlier detection of visual field changes in glaucoma patients. The frequency-doubling perimetry (FDT) is believed to detect glaucoma earlier than SAP. The multifocal visual evoked potential (mfVEP) is an objective test for functional evaluation. Objective: To evaluate the sensitivity and specificity of FDT and mfVEP tests in normal, suspect, and glaucomatous eyes and compare the monocular and interocular mfVEP. Methods: Ninety-five eyes from 95 individuals (23 controls, 33 glaucoma suspects, 39 glaucomatous) were enrolled. All participants underwent a full ophthalmic examination, followed by SAP, FDT, and mfVEP tests. Results: The area under the curve for mean deviation and pattern standard deviation were 0.756 and 0.761, respectively, for FDT, 0.564 and 0.512 for signal and alpha for interocular mfVEP, and 0.568 and 0.538 for signal and alpha for monocular mfVEP. This difference between monocular and interocular mfVEP was not significant. Conclusion: The FDT matrix was superior to mfVEP in glaucoma detection. The difference between monocular and interocular mfVEP in the diagnosis of glaucoma was not significant.
关键词： electrophysiology,glaucomatous eyes,standard automated perimetry
更新于2025-09-09 09:28:46