Michael Kalloniatis1,2, Sieu K Khuu2. 1. Centre for Eye Health, University of New South Wales, Kensington, New South Wales, Australia. 2. School of Optometry and Vision Science, University of New South Wales, Kensington, New South Wales, Australia.
Abstract
PURPOSE: To test the hypothesis that visual field assessment in ocular disease measured with target stimuli within or close to complete spatial summation results in larger threshold elevation compared to when measured with the standard Goldmann III target size. The hypothesis predicts a greater loss will be identified in ocular disease. Additionally, we sought to develop a theoretical framework that would allow comparisons of thresholds with disease progression when using different Goldmann targets. METHODS: The Humphrey Field Analyser (HFA) 30-2 grid was used in 13 patients with early/established optic nerve disease using the current Goldmann III target size or a combination of the three smallest stimuli (target size I, II and III). We used data from control subjects at each of the visual field locations for the different target sizes to establish the number of failed points (events) for the patients with optic nerve disease, as well as global indices for mean deviation (MD) and pattern standard deviation (PSD). RESULTS: The 30-2 visual field testing using alternate target size stimuli showed that all 13 patients displayed more defects (events) compared to the standard Goldmann III target size. The median increase for events was seven additional failed points: (range 1-26). The global indices also increased when the new testing approach was used (MD -3.47 to -6.25 dB and PSD 4.32 to 6.63 dB). Spatial summation mapping showed an increase in critical area (Ac) in disease and overall increase in thresholds when smaller target stimuli were used. CONCLUSIONS: When compared to the current Goldmann III paradigm, the use of alternate sized targets within the 30-2 testing protocol revealed a greater loss in patients with optic nerve disease for both event analysis and global indices (MD and PSD). We therefore provide evidence in a clinical setting that target size is important in visual field testing.
PURPOSE: To test the hypothesis that visual field assessment in ocular disease measured with target stimuli within or close to complete spatial summation results in larger threshold elevation compared to when measured with the standard Goldmann III target size. The hypothesis predicts a greater loss will be identified in ocular disease. Additionally, we sought to develop a theoretical framework that would allow comparisons of thresholds with disease progression when using different Goldmann targets. METHODS: The Humphrey Field Analyser (HFA) 30-2 grid was used in 13 patients with early/established optic nerve disease using the current Goldmann III target size or a combination of the three smallest stimuli (target size I, II and III). We used data from control subjects at each of the visual field locations for the different target sizes to establish the number of failed points (events) for the patients with optic nerve disease, as well as global indices for mean deviation (MD) and pattern standard deviation (PSD). RESULTS: The 30-2 visual field testing using alternate target size stimuli showed that all 13 patients displayed more defects (events) compared to the standard Goldmann III target size. The median increase for events was seven additional failed points: (range 1-26). The global indices also increased when the new testing approach was used (MD -3.47 to -6.25 dB and PSD 4.32 to 6.63 dB). Spatial summation mapping showed an increase in critical area (Ac) in disease and overall increase in thresholds when smaller target stimuli were used. CONCLUSIONS: When compared to the current Goldmann III paradigm, the use of alternate sized targets within the 30-2 testing protocol revealed a greater loss in patients with optic nerve disease for both event analysis and global indices (MD and PSD). We therefore provide evidence in a clinical setting that target size is important in visual field testing.
Authors: Jack Phu; Sieu K Khuu; Michael Yapp; Nagi Assaad; Michael P Hennessy; Michael Kalloniatis Journal: Clin Exp Optom Date: 2017-06-22 Impact factor: 2.742
Authors: Nayuta Yoshioka; Barbara Zangerl; Lisa Nivison-Smith; Sieu K Khuu; Bryan W Jones; Rebecca L Pfeiffer; Robert E Marc; Michael Kalloniatis Journal: Invest Ophthalmol Vis Sci Date: 2017-06-01 Impact factor: 4.799
Authors: Lindsay Rountree; Pádraig J Mulholland; Roger S Anderson; David F Garway-Heath; James E Morgan; Tony Redmond Journal: Sci Rep Date: 2018-02-01 Impact factor: 4.379
Authors: Jack Phu; Sieu K Khuu; Lisa Nivison-Smith; Barbara Zangerl; Agnes Yiu Jeung Choi; Bryan W Jones; Rebecca L Pfeiffer; Robert E Marc; Michael Kalloniatis Journal: Invest Ophthalmol Vis Sci Date: 2017-09-01 Impact factor: 4.799