Evaluation of sensitivity and specificity of spatial resolution and Humphrey automated perimetry in pseudotumor cerebri patients and normal subjects.

To determine the sensitivity and specificity of high-pass resolution perimetry ("ring test"), 18 patients with pseudotumor cerebri (PTC) and 18 age-matched controls were examined with the Humphrey program 24-2 and the ring test. Goldmann perimetry also was done to determine if defects found with the ring test were present with another method. Testing with Humphrey perimetry revealed defects in 15 PTC patients and four control subjects; with the ring test, 13 PTC patients and two control subjects had abnormalities. The disturbed areas in the control subjects with both automated tests were not reproducible. Humphrey perimetry had a sensitivity of 83% and the ring test, 72%. The specificities were Humphrey perimetry, 78% and the ring test, 89%. These differences were not statistically significant. Qualitative assessment of the presence and extent of damage using the pointwise probability plots and graphically displayed raw data showed good correlation of the tests in 11 of the 18 patients. The lack of correlation in four of the patients was caused by the presence of a generalized depression or a peripheral contraction on the Humphrey test; this defect, not present on retesting, may have been related to fatigue or poor motivation. The ring test is a sensitive and specific perimetric technique in patients with PTC.