Pulsar perimetry in the diagnosis of early glaucoma.

Abstract

PURPOSE:

To assess the ability of Pulsar perimetry (Pulsar) in detecting early glaucomatous visual field (VF) damage in comparison with Frequency Doubling Technology (FDT), Scanning Laser Polarimetry (SLP, GDx VCC), and Heidelberg Retina Tomography (HRT).

DESIGN:

Prospective observational cross-sectional case study.

METHODS:

This multicenter study included: 87 ocular hypertensives (OHT); 67 glaucomatous optic neuropathy (GON) patients; 75 primary open-angle glaucoma (POAG) patients; and 90 normals. All patients underwent standard automated perimetry (SAP) HFA 30-2, Pulsar T30W, FDT N-30, HRT II, and GDx VCC. Area under Receiver Operating Characteristic Curves (AROCs) for discriminating between healthy and glaucomatous eyes and agreement among instruments were determined.

RESULTS:

The best parameters for Pulsar, FDT, HRT, and GDx were, respectively: loss variance square root; no. of areas with P< 5%; Cup-Shape-Measure; and Nerve Fiber Indicator (NFI). In detecting POAG eyes, Pulsar (AROC, 0.90) appeared comparable with FDT (0.89) and significantly better than HRT (0.82) and GDx (0.79). For GON, Pulsar ability (0.74) was higher than GDx (0.69) and lower than FDT (0.80) and HRT (0.83). The agreement among instruments ranged from 0.12 to 0.56. Pulsar test duration was significantly shorter than SAP and FDT (P< .001).

CONCLUSIONS:

Pulsar T30W test is a rapid and easy perimetric method, showing higher sensitivity than SAP in detecting early glaucomatous VF loss. Its diagnostic ability is good for detecting early perimetric POAG eyes and fair for GON eyes. Pulsar performance was comparable with FDT, HRT, and GDx, even if the agreement between instruments was poor to fair.

• Authors: Marco Zeppieri, Paolo Brusini, Lucia Parisi, Chris A Johnson, Roberto Sampaolesi, Maria Letizia Salvetat
• Journal: American journal of ophthalmology (Am J Ophthalmol) Vol. 149 Issue 1 Pg. 102-12 (Jan 2010) ISSN: 1879-1891 [Electronic] United States
• PMID: 19800607 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
• Copyright: Copyright 2010 Elsevier Inc. All rights reserved.

Topics

• Aged
• Area Under Curve
• Cross-Sectional Studies
• Early Diagnosis
• Female
• Glaucoma, Open-Angle (diagnosis, physiopathology)
• Humans
• Intraocular Pressure (physiology)
• Male
• Middle Aged
• Nerve Fibers (pathology)
• Ocular Hypertension (diagnosis, physiopathology)
• Optic Disk (pathology)
• Optic Nerve Diseases (diagnosis, physiopathology)
• Prospective Studies
• ROC Curve
• Reproducibility of Results
• Sensitivity and Specificity
• Tomography
• Vision Disorders (diagnosis, physiopathology)
• Visual Field Tests (methods)
• Visual Fields