title: A method to measure visual field sensitivity at the edges of glaucomatous scotomata.
abstract: OBJECTIVE
  To develop and evaluate a method to map glaucomatous visual field (VF) damage by allocating additional test points to the standard 6° interval VF test pattern, considering the distribution of VF scotomata.
  
  
  METHODS
  Subjects comprised 22 glaucomatous patients. Gradients of sensitivity were calculated for "squares" of test points in a patient's 24-2/30-2 VF results, so that the edges of scotomata could be identified where gradients were steep. Next, 10 new VF points were placed in these locations for each patient. Each patient's VF was then measured using this novel test grid (52 standard 24-2 test points and 10 additional points examined concurrently) on two separate occasions. The absolute difference between the measured sensitivity at each new additional test point and the average of the sensitivities of its surrounding four test points was calculated (Δave). The intra- and intervisit reproducibility of the additional test points' thresholds was calculated. Finally, fluctuation of overall VF damage was estimated using the intraclass correlation coefficient (ICC) and the coefficient of variation (CV).
  
  
  RESULTS
  The average of the sensitivities (Δave) increased as the gradient of the plane steepened, whereas the reproducibility of the additional test points' thresholds remained stable. ICC was significantly higher and CV was significantly lower for the novel test grid compared with the standard 24-2 test pattern.
  
  
  CONCLUSIONS
  It may be advantageous to increase the density of VF test points where there are large local differences in VF sensitivity. These additional measurements may result in more reproducible and well-defined estimates of scotomata.
authors.affiliation: Department of Ophthalmology, the University of Tokyo, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Aoyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Murata
authors.forename: Mayumi
authors.initials: M
authors.lastname: Tahara
authors.forename: Mieko
authors.initials: M
authors.lastname: Yanagisawa
authors.forename: Kazunori
authors.initials: K
authors.lastname: Hirasawa
authors.forename: Chihiro
authors.initials: C
authors.lastname: Mayama
authors.forename: Ryo
authors.initials: R
authors.lastname: Asaoka
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012165:Retinal Ganglion Cells / Q000502:physiology*; D012607:Scotoma / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D041623:Tomography, Optical Coherence / Q000379:methods; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields
keywords: glaucoma; test grid; visual field