Development of efficient threshold strategies for frequency doubling technology perimetry using computer simulation.
OBJECTIVE
To develop new test procedures for frequency-doubling technology (FDT) perimetry that improve performance beyond those currently used.


METHODS
Two novel threshold estimation procedures were evaluated: a rapid, efficient binary search technique (REBS) and a maximum-likelihood estimation (ZEST) procedure. A computerized visual field simulation model was developed to determine the accuracy and efficiency of these procedures. This model was constructed using previously derived characteristics of FDT perimetry from both normal observers (n = 506) and those with glaucomatous visual field loss (n = 352). The computer simulation program was used to determine the best parameters for the two new procedures and the effect of variability and response errors on algorithm performance. Comparisons were made to the performance of the modified binary search (MOBS) procedure used in the current commercial implementation of the FDT perimeter.


RESULTS
Both the optimized REBS and ZEST procedures approximately halved the time required for FDT threshold testing without loss of accuracy or reproducibility.


CONCLUSIONS
With suitable parameter choices, comparable performance was achieved using either ZEST or REBS. Simulation results indicate that accurate thresholds can be measured with an optimized ZEST or REBS procedure in approximately half the time required by traditional estimation methods.
Turpin
Andrew
A
Discoveries in Sight, Devers Eye Institute, Legacy Clinical Research and Technology Center, Portland, Oregon, USA.
McKendrick
Allison M
AM
Johnson
Chris A
CA
Vingrys
Algis J
AJ
D000368:Aged; D000465:Algorithms; D003198:Computer Simulation; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D016013:Likelihood Functions; D008875:Middle Aged; D008954:Models, Biological; D014786:Vision Disorders / Q000175:diagnosis*; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields