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Balwantray C. Chauhan, PhD; Philip H. House, MD; Terry A. McCormick, BA; Raymond P. LeBlanc, MD

Arch Ophthalmol. 1999;117:24-33.

Objective  To determine whether high-pass resolution perimetry detected glaucomatous visual field progression earlier than conventional perimetry.

Methods  In a prospective longitudinal study, we observed 113 patients with open-angle glaucoma and with early to moderate visual field damage and 119 healthy control subjects. Each subject underwent testing at 6-month intervals using conventional and high-pass resolution perimetry (program 30-2 of the Humphrey Field Analyzer [Humphrey Instruments, Inc, San Leandro, Calif] and the Ring program of the Ophthimus perimeter [Hi-Tech Vision, Göteborg, Sweden], respectively). Our predetermined criterion for progression with conventional perimetry was the presence of at least 4 overlapping nonedge locations outside the fifth percentile for test-retest variability of threshold deviations (defined by the Glaucoma Change Probability Analysis of the Statpac 2 program) in 2 of 3 consecutive visual fields. We employed the identical criterion for progression with high-pass resolution perimetry using our own test-retest variability data. We repeated this procedure in the controls to measure the false-positive rate of progression.

Results  Patients were observed for a median of 4.5 years and 11 examinations with each technique. Fifty-seven patients (50.4%) did not show progression with either technique. Twenty-four patients (21.2%) showed progression with high-pass resolution perimetry alone, whereas 6 (5.3%) showed progression with conventional perimetry alone. Of the remaining 26 patients (23.0%) who showed progression with both techniques, 14 (54%) showed progression with high-pass resolution perimetry first (median, 12 months earlier); 5 (19%), with conventional perimetry first (median, 6 months earlier); and 7 (27%), with both techniques at the same time. Controls were observed for a median of 5 years and 11 examinations with each technique. One control (0.8%) showed progression with high-pass resolution perimetry.

Conclusions  Our results suggest that high-pass resolution perimetry detects glaucomatous visual field progression earlier than conventional perimetry in most patients with progression.

From the Departments of Ophthalmology (Drs Chauhan and LeBlanc and Ms McCormick) and Physiology and Biophysics (Dr Chauhan), Dalhousie University, Halifax, Nova Scotia; and Lions Eye Institute, Nedlands, Western Australia (Dr House). The authors have no proprietary interest in any of the instruments or techniques reported herein.

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