Abstract

P 165

Perimetric tests using peripheral stimulation in early glaucoma

Bellios N., Horn F. K., Lämmer R., Gottschalk K., Dehne K., Juenemann A. G. M.
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Erlangen;
Erlangen Glaucoma Research SFB 539

Objective: Early glaucomatous visual field defects can occur outside the central 30°, which is usually being examined in perimetric tests used for glaucoma diagnosis and screening. This study aims to evaluate the diagnostic sensitivity of peripheral suprathreshold stimulation in open angle glaucoma before the development of reproducible visual field damage in standard 30° automatic white on white perimetry.
Methods: 737 eyes of 460 patients (Age: 35 to 69 years; visual acuity 0.8 or greater) from the Erlanger glaucoma registry were examined in this study. All included patients underwent a standardized glaucoma examination including Octopus 500EZ static perimetry (G1 program), 162 eyes of 111 patients also received the Humphrey Field Analyser (model 750i) 135-point test pattern for detecting peripheral visual field losses. Sensitivity and specificity were calculated for any single test point in phase 3 of the G1 test pattern and the Humphrey 135-point pattern and cluster analysis/score was performed.
Results: 72 of 319 (22.6%) eyes with preperimetric glaucoma had peripheral visual field defects in phase 3 of the G1 program (normals: 42 of 418; 10.05%) and 33 of 102 (32.35%) eyes with preperimetric glaucoma in the Humphrey 135-point test pattern (normals: 5 of 60; 8.33%). For both examination modalities highest sensitivity was found in test locations in the superior and inferior nasal mid periphery corresponding to neuroretinal rim loss predominantly in the temporal sector in early glaucomatous optic disc atrophy.
Conclusions: Positive test results using suprathreshold stimulation in the nasal mid periphery can be found in approximately one third of the patients with preperimetric glaucoma. Longitudinal studies will show if this is useful for prediction of perimetric manifestation of the disease.

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