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Abstract #54808 Published in IGR 15-3
Efficacy of SLO-Microperimetry and Humphrey for evaluating macular sensitivity changes in advanced glaucoma
Kulkarni SV; Coupland SG; Stitt DM; Hamilton J; Brownstein JJ; Damji KFCanadian Journal of Ophthalmology 2013; 48: 406-412
OBJECTIVE: To compare the efficacy of scanning laser ophthalmoscope microperimetry (SLO-MP) and Humphrey visual fields in detecting macular sensitivity changes in advanced glaucoma. DESIGN: Prospective cohort study. PARTICIPANTS: 25 patients with advanced primary open angle glaucoma and 2 consecutive abnormal Humphrey 10-2 SITA Standard visual field tests. METHODS: Thirty-six eyes of 25 patients with 2 consecutive abnormal Humphrey 10-2 SITA Standard (H10) visual fields were retested with a modified 10-2 SLO-MP within 3 months of the last reliable H10. A standardized grid was used to mark the macula. Primary outcome was change in mean macular sensitivity (dB; H10 and SLO-MP) in relation to mean macular retinal nerve fibre layer (RNFL) thickness (µm) by SLO- optical coherence tomography (SLO-OCT). Secondary outcome was comparison of reliability indices for both tests. Linear regression was used for analysis. RESULTS: Mean macular sensitivity was significantly lower in SLO-MP (9.33 ± 3.37 dB) than H10 (18.83 ± 6.46 dB; p < 0.0001). Mean macular RNFL thickness correlated significantly with retinal sensitivity by both SLO-MP (r = 0.39, p < 0.02) and H10 (r = 0.37, p < 0.03). Fixation losses were better controlled in SLO-MP (0.38 ± 1.1) than H10 (4.28 ± 7.9; p = 0.008). False-positive responses were similar (SLO-MP: 2.25 ± 4.53, H10: 1.78 ± 3.33; p = 0.80). A statistically significant difference was noted in the false-negative responses (SLO-MP: 26.87 ± 25.24, H10: 5.33 ± 9.70; p < 0.0001). CONCLUSIONS: Macular sensitivity determined by both H10 and SLO-MP correlates significantly with mean macular RNFL thickness measured by SLO-OCT. Precise localization of the macula in SLO-MP results in lower fixation losses. Detection of denser field defects by SLO-MP results in higher false-negative responses. A larger sample size is needed to further study the value of this diagnostic tool.
University of Ottawa and Ottawa Hospital Research Institute, Ottawa, Ont. Electronic address: skulkarni@ohri.ca.
Full articleClassification:
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)