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

      Abstract

      Objective

      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.

      Design

      Prospective, observational study.

      Participants

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

      Methods

      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.

      Results

      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).

      Conclusions

      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.

      Résumé

      Objet

      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).

      Nature

      Observation prospective.

      Participants

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

      Méthodes

      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.

      Résultats

      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).

      Conclusions

      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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      References

        • Pascolini D.
        • Mariotti S.P.
        Global estimates of visual impairment: 2010.
        Br J Ophthalmol. 2012; 96: 614-618
        • Resnikoff S.
        • Pascolini D.
        • Etya’ale D.
        • et al.
        Global data on visual impairment in the year 2002.
        Bull World Health Organ. 2004; 82: 844-851
        • Weinreb R.N.
        • Khaw P.T.
        Primary open-angle glaucoma.
        Lancet. 2004; 363: 1711-1720
        • Tole D.M.
        • Edwards M.P.
        • Davey K.G.
        • Menage M.J.
        The correlation of the visual field with scanning laser ophthalmoscope measurements in glaucoma.
        Eye (Lond). 1998; 12: 686-690
        • Geimer S.A.
        Glaucoma diagnostics.
        Acta Ophthalmol. 2013; 91: 1-32
        • San Laureano J.
        When is glaucoma really glaucoma?.
        Clin Exp Optom. 2007; 90: 376-385
        • Sample P.A.
        • Medeiros F.A.
        • Racette L.
        • et al.
        Identifying glaucomatous vision loss with visual-function-specific perimetry in the diagnostic innovations in glaucoma study..
        Invest Ophthalmol Vis Sci. 2006; 47: 3381-3389
        • Johnson C.A.
        • Adams A.J.
        • Casson E.J.
        • Brandt J.D.
        Blue-on-yellow perimetry can predict the development of glaucomatous visual field loss.
        Arch Ophthalmol. 1993; 111: 645-650
        • Johnson C.A.
        • Brandt J.D.
        • Khong A.M.
        • Adams A.J.
        Short-wavelength automated perimetry in low-, medium-, and high-risk ocular hypertensive eyes. Initial baseline results.
        Arch Ophthalmol. 1995; 113: 70-76
        • Racette L.
        • Sample P.A.
        Short-wavelength automated perimetry.
        Ophthalmol Clin North Am. 2003; 16 (vi-vii): 227-236
        • Sample P.A.
        • Weinreb R.N.
        Color perimetry for assessment of primary open-angle glaucoma.
        Invest Ophthalmol Vis Sci. 1990; 31: 1869-1875
        • Jansonius N.M.
        • Heeg G.P.
        The Groningen Longitudinal Glaucoma Study. II. A prospective comparison of frequency doubling perimetry, the GDx nerve fibre analyser and standard automated perimetry in glaucoma suspect patients.
        Acta Ophthalmol. 2009; 87: 429-432
        • Quaid P.T.
        • Flanagan J.G.
        Defining the limits of flicker defined form: effect of stimulus size, eccentricity and number of random dots.
        Vision Res. 2005; 45: 1075-1084
        • Quaid P.T.
        • Simpson T.L.
        • Flanagan J.G.
        Frequency doubling illusion: detection vs. form resolution.
        Optom Vis Sci. 2005; 82: 36-42
        • Rogers-Ramachandran D.C.
        • Ramachandran V.S.
        Psychophysical evidence for boundary and surface systems in human vision.
        Vision Res. 1998; 38: 71-77
        • McKendrick A.M.
        • Badcock D.R.
        • Morgan W.H.
        The detection of both global motion and global form is disrupted in glaucoma.
        Invest Ophthalmol Vis Sci. 2005; 46: 3693-3701
        • Livingstone M.S.
        • Hubel D.H.
        Psychophysical evidence for separate channels for the perception of form, color, movement, and depth.
        J Neurosci. 1987; 7: 3416-3468
        • Ramachandran V.S.
        • Rogers-Ramachandran D.C.
        Phantom contours: a new class of visual patterns that selectively activates the magnocellular pathway in man.
        Bull Psychonom Soc. 1991; 29: 391-394
        • Flanagan J.
        • Williams-Lyn D.
        • Trope G.
        • Hatch W.
        • Harrison E.
        The phantom contour illusion letter test: a new psychophysical test for glaucoma.
        Perimetry Update. 1994; 95: 405-409
        • Johnson C.A.
        • Cioffi G.A.
        • Liebmann J.R.
        • Sample P.A.
        • Zangwill L.M.
        • Weinreb R.N.
        The relationship between structural and functional alterations in glaucoma: a review.
        Semin Ophthalmol. 2000; 15: 221-233
        • Fuertes-Lazaro I.
        • Sanchez-Cano A.
        • Ferreras A.
        • Larrosa J.M.
        • Garcia-Martin E.
        • Pablo L.E.
        Topographic relationship between frequency-doubling technology threshold values.
        Acta Ophthalmol. 2012; 90: e144-e150
        • Garway-Heath D.F.
        • Holder G.E.
        • Fitzke F.W.
        • Hitchings R.A.
        Relationship between electrophysiological, psychophysical, and anatomical measurements in glaucoma.
        Invest Ophthalmol Vis Sci. 2002; 43: 2213-2220
        • Johnson C.A.
        • Sample P.A.
        • Zangwill L.M.
        • et al.
        Structure and function evaluation (SAFE): II. Comparison of optic disk and visual field characteristics.
        Am J Ophthalmol. 2003; 135: 148-154
        • Chauhan B.C.
        • McCormick T.A.
        • Nicolela M.T.
        • LeBlanc R.P.
        Optic disc and visual field changes in a prospective longitudinal study of patients with glaucoma: comparison of scanning laser tomography with conventional perimetry and optic disc photography.
        Arch Ophthalmol. 2001; 119: 1492-1499
        • Sommer A.
        • Katz J.
        • Quigley H.A.
        • et al.
        Clinically detectable nerve fiber atrophy precedes the onset of glaucomatous field loss.
        Arch Ophthalmol. 1991; 109: 77-83
        • Strouthidis N.G.
        • Scott A.
        • Peter N.M.
        • Garway-Heath D.F.
        Optic disc and visual field progression in ocular hypertensive subjects: detection rates, specificity, and agreement.
        Invest Ophthalmol Vis Sci. 2006; 47: 2904-2910
        • Weber A.J.
        • Harman C.D.
        Structure-function relations of parasol cells in the normal and glaucomatous primate retina.
        Invest Ophthalmol Vis Sci. 2005; 46: 3197-3207
        • Hodapp E.
        • Parrish R.K.
        • Anderson D.R.
        Clinical Decisions in Glaucoma.
        Mosby, St. Louis1993
        • Susanna Jr, R.
        • Vessani R.M.
        Staging glaucoma patient: why and how?.
        Open Ophthalmol J. 2009; 3: 59-64
        • Mills R.P.
        • Budenz D.L.
        • Lee P.P.
        • et al.
        Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease..
        Am J Ophthalmol. 2006; 141: 24-30
        • Lamparter J.
        • Russell R.A.
        • Schulze A.
        • Schuff A.C.
        • Pfeiffer N.
        • Hoffmann E.M.
        Structure-function relationship between FDF, FDT, SAP, and scanning laser ophthalmoscopy in glaucoma patients.
        Invest Ophthalmol Vis Sci. 2012; 53: 7553-7559
        • Goren D.
        • Flanagan J.G.
        Is flicker-defined form (FDF) dependent on the contour?.
        J Vis. 2008; 8: 1-11
        • Horn F.K.
        • Tornow R.P.
        • Juenemann A.G.
        • Laemmer R.
        • Kremers J.
        Perimetric measurements with flicker defined form stimulation in comparison to conventional perimetry and retinal nerve fiber measurements..
        Invest Ophthalmol Vis Sci. 2014; 55: 2317-2323
        • Mikelberg F.S.
        • Wijsman K.
        • Schulzer M.
        Reproducibility of topographic parameters obtained with the Heidelberg retina tomograph.
        J Glaucoma. 1993; 2: 101-103
        • Strouthidis N.G.
        • Garway-Heath D.F.
        New developments in Heidelberg retina tomograph for glaucoma.
        Curr Opin Ophthalmol. 2008; 19: 141-148
        • Bathija R.
        • Zangwill L.
        • Berry C.C.
        • Sample P.A.
        • Weinreb R.N.
        Detection of early glaucomatous structural damage with confocal scanning laser tomography.
        J Glaucoma. 1998; 7: 121-127
        • Ho Y.H.
        • Butty Z.
        • Anraku A.
        • Buys Y.M.
        • Trope G.E.
        • Flanagan J.G.
        Structure-function relationship between scanning laser tomography, flicker defined form perimetry and standard automated perimetry in patients with glaucoma.
        ARVO E-Abstract. 2011; 5076/A565
        • Garway-Heath D.F.
        • Poinoosawmy D.
        • Fitzke F.W.
        • Hitchings R.A.
        Mapping the visual field to the optic disc in normal tension glaucoma eyes.
        Ophthalmology. 2000; 107: 1809-1815
        • Hasler S.
        • Sturmer J.
        [First experience with the Heidelberg Edge Perimeter(R) on patients with ocular hypertension and preperimetric glaucoma].
        Klin Monbl Augenheilkd. 2012; 229: 319-322