DEVELOPMENT & EVALUATION OF A CONTRAST SENSITIVITY PERIMETRY TEST FOR PATIENTS WITH GLAUCOMA
Aliya Hot 1*,
Mitchell Dul 2,
and
William H. Swanson 3
1 SUNY College of Optometry, Astoria, New York, United States
2 Glaucoma Institute, SUNY College of Optometry, New York, New York, United States
3 School of Optometry, Indiana University, Bloomington, Indiana, United States
* To whom correspondence should be addressed. E-mail: alichkahot{at}gmail.com.
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Abstract |
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PURPOSE: To design a contrast sensitivity perimetry (CSP) protocol which decreases variability in glaucomatous defects while maintaining good sensitivity to glaucomatous loss.
METHODS: Twenty patients with glaucoma and twenty control subjects were tested with a CSP protocol implemented on a monitor-based testing station. The protocol tested 26 locations over the central visual field, using Gabor patches with a peak spatial frequency of 0.4 cycles per degree and a two-dimensional spatial Gaussian envelope with most of the energy concentrated within a 4 degree circular region. Threshold was estimated with a staircase method. Patients and ten age-similar controls were also tested on conventional automated perimetry (CAP) using the 24-2 pattern with the SITA Standard testing strategy. Neuroretinal rim area of the patients was measured using the Heidelberg Retina Tomograph II. Bland-Altman analysis of agreement was used to assess test-retest variability, compare depth of defect for the two perimetric tests, and investigate the relations between contrast sensitivity and neuroretinal rim area.
RESULTS: Variability showed less dependence on defect depth for CSP than for CAP (Z=9.3, p < 0.001). Defect depth was similar for CAP and CSP when averaged by quadrant (r=0.26, p > 0.13). The relation between defect depth and rim area was more consistent for CSP than for CAP (Z=9, p < 0.001).
CONCLUSION: Our implementation of CSP was successful in reducing test-retest variability in glaucomatous defects. CSP was in general agreement with CAP in terms of depth of defect and was in better agreement than CAP with HRT rim area.
Key Words:
glaucoma, visual field, contrast sensitivity
