Abstract
The ability of oculokinetic perimetry (OKP) to detect glaucomatous central visual field loss was assessed by comparison with the results of Humphrey visual field analysis (HVFA) in a group of patients attending a glaucoma clinic. Fifty-six patients with stable visual fields and good reliability indices on previous automated perimetry examinations underwent programmes 24-1 or 24-2 of the Humphrey visual field analyser and the results compared with those of a field test using a hand-held OKP chart. Forty-three patients had a glaucomatous visual field defect demonstrated by HVFA, and 35 showed a defect to OKP. Thirteen patients were shown to have normal fields on HVFA, and in 21 patients the OKP test was normal. Comparison of the two test results showed that of the 35 patients with abnormal OKP tests, in 26 the result was a true positive (HVFA also abnormal) and in 9 a false positive (HVFA normal). In the 21 patients with negative OKP tests the results were judged false negatives in 13 (HFVA showed glaucomatous visual field loss) while in 8 they were true negatives (HVFA normal). Therefore the sensitivity of OKP for the detection of glaucomatous visual field loss was 60.5% and the specificity for the identification of individuals with glaucomatous visual field loss was 61.5%. In the 26 patients with true positive results there were 36 eyes with positive OKP charts corresponding to defects on HVFA. Correlation of the number of defects on OKP with the mean deviation and corrected pattern standard deviation of their respective HVFA charts showed a near linear correlation. However, when between one and three points were missed on OKP this loss was equally likely to represent a false positive result as it was to represent the presence of glaucomatous field loss. Analysis of the 26 true positive patients' fields showed that a point missed on OKP corresponded to an average depression of retinal sensitivity of 20.8 decibels on HVFA. However, in 50% of these patients' fields OKP also failed to detect defects of, on average, 19.6 decibels in another quadrant of the field. This study shows that OKP can detect relatively advanced glaucomatous visual field loss, but the low sensitivity and specificity of the test makes this device unsuitable for glaucoma screening.
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Wishart, P. Oculokinetic perimetry compared with Humphrey visual field analysis in the detection of glaucomatous visual field loss. Eye 7, 113–121 (1993). https://doi.org/10.1038/eye.1993.24
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DOI: https://doi.org/10.1038/eye.1993.24
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