New perimetric threshold test algorithm with dynamic strategy and tendency oriented perimetry (TOP) in glaucomatous eyes.

PURPOSE

To investigate the time-wise reliability and efficiency of two new perimetric test algorithms, two computerised static threshold perimetry strategies, namely dynamic strategy (DS) and tendency oriented perimetry (TOP), were compared with the standard full-threshold strategy (normal strategy, NS).

METHODS

We examined 41 eyes of 41 normal individuals without any ocular disease and 36 eyes of 36 glaucomatous patients, with the NS (4-to-2 dB), DS and TOP using an Octopus 1-2-3 perimeter. We analysed test time, stimulus time and the two global indices, mean sensitivity (MS) and loss variance (LV). Program 32X was used as test grid pattern.

RESULTS

The mean test time for the NS was reduced by 52% with the DS and by 78% with the TOP strategy. Concerning the global indices, the MS value did not differ among the three strategies in the control or glaucoma group. However, the LV value was lower in the TOP strategy compared with the other two strategies in the glaucoma group. This suggested that the TOP strategy underestimated local glaucomatous visual field defects. The ability to detect early-stage glaucoma with the DS and TOP was inferior to that with the NS.

CONCLUSIONS

The DS was more efficient than the TOP strategy for the detection of early glaucomatous defects, whereas the TOP strategy required less testing time. The TOP strategy may be an appropriate approach for patients in whom time-consuming perimetry is not possible, or in whom the visual field defect is already advanced.