Visual Field Plots: A Comparison Study between Standard Automated Perimetry and Eye Movement Perimetry

Précis: This Eye movement Perimetry study describes the development of Saccadic Reaction Time based visual field plots which could effectively display the presence, location, and extent of glaucomatous defects and support clinical decision making. Purpose: Eye Movement Perimetry (EMP) is capable of discriminating normal from glaucomatous visual field defects based on average delays in Saccadic Reaction Times (SRT). To classify the presence and extent of age-corrected visual field defects, it is required to create SRT-based probability maps. Aim: To create visual field probability plots based on SRTs and to evaluate their clinical applicability by two glaucoma specialists. Methods: The development phase included 95 controls segregated into 5 age-bins to estimate normative limits of SRT. Next, for the testing phase, a set of 28 healthy subjects & 24 glaucoma patients were recruited who underwent Standard Automated Perimetry (SAP) and EMP visual field testing. Fifty-Two SAP and EMP plots were presented to two glaucoma specialists to classify them as normal/abnormal and to identify the defect location and pattern as 1 or more of seven predefined categories. Results: The glaucoma specialists showed a sensitivity of 100% and a specificity of 93% and 96% for identifying normal versus abnormal visual field. For specialist 1 & 2, 85% & 92% of EMP reports were assigned to the same category as SAP. The reports which did not agree with SAP were graded to a higher defect pattern. The inter-method agreement for specialists 1 and 2 was kappa 0.92 & 0.96 respectively. Conclusions: SRT-based visual field probability plots provided a comprehensive summary of an individual's visual field status and showed comparable clinical applicability to that of SAP plots.

• View at Publisher
• View at Scopus