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      Discriminating Ability of Humphrey Matrix Perimetry in Early Glaucoma Patients

      , , ,

      Ophthalmologica

      S. Karger AG

      Frequency doubling, Humphrey Matrix, Glaucoma, early

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          Abstract

          Purpose: To determine the discriminating ability of some parameters provided by Humphrey Matrix perimetry for early glaucoma detection. Methods: A prospective cross-sectional study was performed. Sixty-five primary open-angle glaucoma patients with early-stage visual field defects on standard automated perimetry (mean deviation = –1.98 ± 1.93 dB) and 56 healthy subjects were included. All subjects performed the Humphrey Matrix perimetry with a threshold 30-2 strategy. The receiver operating characteristic (ROC) curve was constructed for each parameter and calculated the area under the ROC curve (AUC) to seek the best discriminating parameter for early glaucoma detection. Results: The AUCs of Humphrey Matrix perimetry with the mean deviation, pattern standard deviation, Glaucoma Hemifield Test, number of points that have a p < 5% in pattern deviation plot (PDP) and number of points that have a p < 1% in PDP were 0.795, 0.808, 0.689, 0.985 and 0.946, respectively. Conclusion: Humphrey Matrix perimetry allowed accurate discrimination between normal and early glaucomatous eyes. The number of points that had a p < 5% in PDP was the best discriminating parameter for early glaucoma detection using Humphrey Matrix perimetry.

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          Most cited references 8

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          Statistical Approaches to the Analysis of Receiver Operating Characteristic (ROC) Curves

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            Frequency doubling technology perimetry abnormalities as predictors of glaucomatous visual field loss.

            To determine whether frequency doubling technology (FDT) perimetry results predict glaucomatous visual field defects, as assessed by standard automated perimetry (SAP), in a glaucoma suspect population. Longitudinal observational study. The study included 105 eyes of 105 glaucoma suspect patients, with a mean follow-up time of 41 +/- 17 months. Glaucoma suspects had either intraocular pressure (IOP) higher than or equal to 23 mm Hg or glaucomatous optic neuropathy by stereophotograph assessment. All patients had normal SAP visual fields at baseline. A baseline FDT test was performed within 3 months of the normal SAP examination. Several baseline FDT parameters and other variables (age, gender, IOP, central corneal thickness, SAP visual field indices, and stereophotograph assessment) were investigated by univariate and multivariate Cox proportional hazards models to obtain hazard ratios (HR) and identify factors that predicted which patients had SAP glaucomatous visual field loss during follow-up. Seventeen patients (16%) developed repeatable SAP visual field abnormality during follow-up. An abnormal FDT examination at baseline predicted the development of SAP visual field conversion in both univariate (HR = 3.17; 95% confidence interval [CI] = 1.22-8.25; P =.018) and multivariate models (Adjusted HR = 3.68; 95% CI = 1.06-12.8; P =.04). The analysis of FDT examinations during follow-up revealed that in 59% of converters the FDT abnormalities preceded SAP visual field loss by as much as 4 years. Also, the initial development of glaucomatous visual field loss as measured by SAP occurred in regions that had previously demonstrated abnormalities on FDT testing. Functional abnormalities detected by FDT perimetry were predictive of the future onset and location of SAP visual field loss among glaucoma suspect patients.
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              Properties of perimetric threshold estimates from full threshold, ZEST, and SITA-like strategies, as determined by computer simulation.

              To investigate the accuracy and precision of threshold estimates returned by two Bayesian perimetric strategies, staircase-QUEST or SQ (a Swedish interactive threshold algorithm [SITA]-like strategy) and ZEST (zippy estimation by sequential testing), and to compare these measures with those of the full-threshold (FT) algorithm. A computerized visual field simulation model was developed to compare the performance (accuracy, precision, and number of presentations) of the three algorithms. SQ implemented aspects of the SITA algorithm that are in the public domain. The simulation was tested by using standard automated perimetry (SAP) visual field data from 265 normal subjects and 163 observers with glaucomatous visual field loss and by exploring the effect of response variability and response errors on algorithm performance. SQ was faster than FT or ZEST, with a comparable mean error when simulating field tests on patients. Point-wise analysis revealed similar error and standard deviation of error as a function of threshold for FT and SQ. If the initial estimate of threshold for either procedure was incorrect, the means and standard deviations of the error increased markedly. ZEST produced more accurate thresholds than did the other two strategies when the initial estimate was removed from the true threshold. When simulated patients made errors, the accuracy and precision of sensitivity estimates were poor when the initial estimate of threshold either overestimated or underestimated the true threshold. This was particularly so for FT and SQ. ZEST demonstrated more consistent error properties than the other two measures.
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                Author and article information

                Journal
                OPH
                Ophthalmologica
                10.1159/issn.0030-3755
                Ophthalmologica
                S. Karger AG
                0030-3755
                1423-0267
                2007
                April 2007
                20 April 2007
                : 221
                : 3
                : 195-199
                Affiliations
                Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea
                Article
                99301 Ophthalmologica 2007;221:195–199
                10.1159/000099301
                17440283
                © 2007 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 1, Tables: 2, References: 17, Pages: 5
                Categories
                Original Paper

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