Flicker defined form, standard perimetry and Heidelberg retinal tomography: Structure-function relationships



      To compare flicker defined form (FDF) perimetry using the Heidelberg edge perimeter (HEP) with standard automated perimetry (SAP) on the Humphrey visual field (HVF) analyzer and to compare their relationship to structural measurements acquired with the Heidelberg retina tomograph.


      Prospective, observational study.


      Thirty-one glaucomatous eyes with varying severity and 13 normal control eyes were included in this analysis.


      All subjects underwent FDF testing on the HEP using the 24-2 protocol by the adaptive staircase thresholding algorithm standard strategy and SAP on the HVF analyzer 750 II using the SITA-Standard 24-2 test. Heidelberg retina tomography (HRT) testing was obtained for each patient. Spearman correlation coefficient, mean deviation (MD), and pattern standard deviation measurements by both machines were compared.


      FDF and SAP MD were significantly correlated (r = 0.81, p < 0.001). FDF and SAP MD were significantly correlated with HRT cup/disc ratio (FDF MD: p < 0.001; SAP MD: p = 0.003), disc area (FDF MD: p = 0.005; SAP MD: p = 0.059), rim volume (FDF MD: p < 0.001; SAP MD: p < 0.001), and retinal nerve fibre layer (FDF MD: p < 0.001; SAP MD: p < 0.001).


      This pilot study shows that the MD parameter of FDF correlated with SAP results. FDF and SAP had significant correlations with HRT parameters in glaucomatous and healthy eyes. The potential utility of FDF in the clinical management of glaucoma requires further investigation.



      Comparer les performances du nouveau test de périmétrie non conventionnelle, le Flicker Defined Form (FDF), fourni par le périmètre Heidelberg (HEP), et celles du test de périmétrie automatisée standard (PAS), fourni par l’analyseur de vision Humphrey (AVH), puis comparer les rapports entre ces méthodes et les mesures structurelles obtenues grâce à la tomographie rétinienne de Heidelberg (TRH).


      Observation prospective.


      31 yeux glaucomateux à divers degrés de gravité et un groupe témoin composé de 13 yeux normaux.


      Tous les sujets ont subi un test de FDF fourni par le HEP à l’aide du protocole 24-2 selon la stratégie standard de l’algorithme adaptatif ASTA, et un test de PAS fourni par l’AVH 750 II, selon le test standard SITA 24.2. Chaque sujet a aussi subi une TRH. Le coefficient de corrélation de Spearman, l’écart à la moyenne (EM) et l’écart type pour chaque modèle (ETM) sur les deux appareils ont été comparés.


      Il existe une corrélation significative entre l’écart à la moyenne du test de FDF et du test de PAS (r = 0,81; p < 0,001). Une corrélation significative existe aussi entre l’écart à la moyenne du test de FDF et du test de PAS et le rapport « cup/disc » obtenu par TRH (EM FDF p < 0,001; EM PAS p = 0,003), la superficie du disque (EM FDF p = 0,005; EM PAS p = 0,059), le volume de la bordure(EM FDF p < 0,001; EM PAS p < 0,001) et la couche des fibres nerveuses rétiniennes (EM FDF p < 0,001; EM PAS p < 0,001).


      Cette étude pilote montre une corrélation entre le paramètre de l’écart à la moyenne (EM) du test de FDF et les résultats des tests de PAS. Il y avait également des corrélations significatives entre les tests de FDF et de PAS et les paramètres de la TRH chez les patients atteints de glaucome et les patients du groupe témoin. L’utilité potentielle du test de FDF pour la gestion clinique du glaucome nécessite un examen plus approfondi.
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