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Comparison of frequency doubling and flicker defined form perimetry in early glaucoma

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare perimetric data based on the second-generation frequency doubling technology (FDT) and on flicker defined form (FDF) stimulation in early glaucoma patients.

Methods

Seventy-two experienced glaucoma patients and 50 healthy subjects of the Erlangen Glaucoma Registry participated in the study. The definition of glaucoma was solely based on optic disc appearance. All patients underwent FDF perimetry (HEP), FDT perimetry (Matrix), standard automated perimetry (SAP, Octopus), and peripapillar measurements of the RNFL thickness (Spectralis OCT). Exclusion criteria were: mean defect (MD) in SAP > 6 dB, eye diseases other than glaucoma, or non-reliable FDF or FDT measurements. Statistical analyses included comparison of the standard indices and correlations between methods. Venn-diagrams show the number of patients with abnormal results in HEP, Matrix, SAP, and mean RNFL thickness.

Results

Mean defect data from FDT and FDF perimetry were strongly correlated (R = −0.85, P <0.001). In this cohort of early glaucoma patients, the MD values were 6.1 ± 5.0 dB (FDF) and 4.5 ± 4.1 dB (FDT). Sensitivity in this patient group was 65 % for FDF-MD, 60 % for FDT-MD, and 60 % for RNFL-thickness, all at a specificity of 95 %. The correlation analysis between local RNFL thickness and corresponding visual defects revealed significant Spearman correlation coefficients for the arcuate bundles of the visual field (FDF-inferior: R = −0.65, FDF-superior: R = −0.74, FDT-inferior: R = −0.55, FDT-superior: R = −0.72).

Conclusion

FDF and FDT stimulations can be used to detect patients with early glaucoma. Combined consideration of RNFL thickness and results from one of these perimetric tests can increase the total number of detected patients.

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Authors and Affiliations

  1. Department of Ophthalmology and University Eye Hospital, Friedrich-Alexander University Erlangen-Nürnberg, Schwabachanlage 6, D-91054, Erlangen, Germany

    Folkert K. Horn, Vicki Scharch, Christian Y. Mardin, Robert Lämmer & Jan Kremers

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  1. Folkert K. Horn
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Correspondence to Folkert K. Horn.

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Funding

No financial support was received for the study. The Matrix and the HEP instruments were given as loan from the manufacturers for the time of the study. The manufacturers had no role in the design or conduct of this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Horn, F.K., Scharch, V., Mardin, C.Y. et al. Comparison of frequency doubling and flicker defined form perimetry in early glaucoma. Graefes Arch Clin Exp Ophthalmol 254, 937–946 (2016). https://doi.org/10.1007/s00417-016-3286-1

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  • DOI: https://doi.org/10.1007/s00417-016-3286-1

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