Sarossy Marc G, Rezk Sandy, Li Dongzhe, Hadoux Xavier, Jannaud Maxime, Coote Michael A, Ang Ghee Soon, van Wijngaarden Peter, Martin Keith R, Wu Zhichao
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.
Clin Exp Ophthalmol. 2025 Aug;53(6):602-610. doi: 10.1111/ceo.14528. Epub 2025 Mar 24.
To compare the performance of high-resolution microperimetry testing against standard automated perimetry (SAP) for detecting glaucomatous damage seen on optical coherence tomography (OCT) scans.
250 eyes from 200 individuals underwent high-resolution microperimetry testing of a hemifield using a stimulus pattern optimised to sample typical arcuate patterns of visual field loss in glaucoma. SAP was performed using a 24-2 stimulus pattern. The presence of glaucomatous damage in each hemifield was subsequently independently assessed by two graders based on a circumpapillary OCT circle scan, 6×6 mm optic disc-centred OCT volume scan, and 15×15 mm widefield OCT volume scan.
The hemifield-based mean total deviation (MTD) and pointwise sensitivity standard deviation (PSD) for high-resolution microperimetry and SAP were both independently associated with the presence of glaucomatous damage in multivariable logistic regression analyses (p ≤ 0.046). Prediction models developed using these two parameters showed significantly higher performance with high-resolution microperimetry compared to SAP (partial area under the receiver operating characteristic curve [pAUC] = 0.86 and 0.75 respectively; p = 0.007). The performance of microperimetry decreased with decreasing resolution when the MTD and PSD values were derived from every second, third, and sixth test locations (pAUC = 0.85 [p = 0.16], 0.85 [p = 0.044] and 0.84 [p < 0.001] respectively), but they were all significantly better than SAP (p ≤ 0.028 for all).
High-resolution microperimetry enabled improved performance for detecting glaucomatous damage compared to SAP, highlighting the potential value of fundus-tracking and higher-resolution sampling for the detection of glaucomatous visual field loss.
比较高分辨率微视野检测与标准自动视野计（SAP）在检测光学相干断层扫描（OCT）图像上青光眼性损伤方面的性能。
对200名个体的250只眼睛进行了半视野的高分辨率微视野检测，使用优化的刺激模式来采样青光眼典型的弓形视野缺损模式。使用24-2刺激模式进行SAP检测。随后，两名分级人员基于以视乳头为中心的6×6毫米OCT环形扫描、以视盘为中心的15×15毫米宽视野OCT容积扫描，独立评估每个半视野中青光眼性损伤的存在情况。
在多变量逻辑回归分析中，高分辨率微视野检测和SAP的基于半视野的平均总偏差（MTD）和逐点敏感度标准差（PSD）均与青光眼性损伤的存在独立相关（p≤0.046）。使用这两个参数建立的预测模型显示，与SAP相比，高分辨率微视野检测的性能显著更高（受试者操作特征曲线下部分面积[pAUC]分别为0.86和0.75；p = 0.007）。当MTD和PSD值来自每隔一个、第三个和第六个测试位置时，微视野检测的性能随着分辨率降低而下降（pAUC分别为0.85 [p = 0.16]、0.85 [p = 0.044]和0.84 [p < 0.001]），但它们都明显优于SAP（所有p≤0.028）。
与SAP相比，高分辨率微视野检测在检测青光眼性损伤方面具有更高的性能，突出了眼底追踪和更高分辨率采样在检测青光眼性视野缺损方面的潜在价值。
