Abstract
Oculokinetic perimetry (OKP) has been developed to screen for glaucomatous field loss but has relatively poor sensitivity when compared with threshold perimetry.
Forty-two eyes from 42 patients with glaucomatous field loss on Humphrey threshold perimetry and 32 normals performed hand-held OKP under controlled conditions of refraction and lighting. Those who passed the standard test had their OKP cutoff determined with increasing neutral density filters (NDFs) at a new point 15° from fixation in the inferotemporal field (where first glaucomatous defects are rarest). OKP was then repeated with a NDF that increased the ambient light by 0.3 log units from cut off. Of the 16 glaucomatous eyes to pass standard OKP, 9 failed the NDF test, improving the sensitivity from 62% to 83% (p<0.05). These 9 eyes had field defects that were significantly less severe (mean defect 4.85 vs 7.91 (p<0.05) and corrected pattern standard deviation 4.12 vs 7.00 (p<0.05) and were from younger patients (mean age 56 vs 66 years; p<0.05) than those who failed standard OKP. None of the 32 normals failed standard OKP and only 1 of 32 failed the NDF test. The use of NDFs to customise OKP, producing essentially a staged suprathreshold contrast sensitivity test, appears to increase the sensitivity of the OKP screener without degrading its specificity, particularly in younger subjects.
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Vernon, S., Quigley, H. Improving the sensitivity of the OKP visual field screening test with the use of neutral density filters. Eye 8, 406–409 (1994). https://doi.org/10.1038/eye.1994.96
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DOI: https://doi.org/10.1038/eye.1994.96