title: Selective Automated Perimetry Under Photopic, Mesopic, and Scotopic Conditions: Detection Mechanisms and Testing Strategies.
abstract: OBJECTIVE
  Automated scotopic, mesopic, and photopic perimetry are likely to be important paradigms in the assessment of emerging treatments of retinal diseases, yet our knowledge of the photoreceptor mechanisms detecting targets under these conditions remains largely dependent on simian data. We therefore aimed to establish the photoreceptor/postreceptoral mechanisms detecting perimetric targets in humans under photopic, mesopic, and scotopic conditions and to make recommendations for suitable clinical testing strategies for selective perimetry.
  
  
  METHODS
  Perimetric sensitivities within 30° of fixation were determined for eight wavelengths (410, 440, 480, 520, 560, 600, 640, and 680 nm) under scotopic, mesopic (1.3 cd.m-2) and photopic (10 cd.m-2) conditions. Data were fitted with vector combinations of rod, S-cone, nonopponent M+L-cone mechanism, and opponent M- versus L-cone mechanism templates.
  
  
  RESULTS
  Scotopicperimetric sensitivity was determined by rods peripherally and by a combination of rods and cones at, and immediately around, fixation. Mesopic perimetric sensitivity was mediated by M+L-cones and S-cones centrally and by M+L-cones and rods more peripherally. Photopic perimetric sensitivity was determined by an opponent M- versus L-cone, a nonopponent M+L-cone, and an S-cone mechanism centrally and by a combination of an S-cone and an M+L-cone mechanism peripherally.
  
  
  CONCLUSIONS
  Under scotopic conditions, a 480-nm stimulus provides adequate isolation (≥28 dB) of the rod mechanism. Several mechanisms contribute to mesopic sensitivity: this redundancy in detection may cause both insensitivity to broadband white targets and ambiguity in determining which mechanism is being probed with short-wavelength stimuli. M- and L-cone-derived mechanisms are well isolated at 10 cd.m-2: these may be selectively probed by a stimulus at 640 nm (≥ 20 dB isolation).
  In human observers, multiple mechanisms contribute to the detection of Goldmann size III and size V perimetric targets under scotopic, mesopic, and photopic conditions. The relative contribution of these mechanisms appears to differ from those found previously for macaques. Our results furthermore suggest that caution must be exercised when using microperimetric techniques, which are typically conducted under mesopic conditions and which are likely to be important in the assessment of emerging treatments for retinal disease. This is because mesopic background conditions maximize the redundancy of target detection. Furthermore, our results demonstrate that spectral manipulation of the stimulus alone cannot be used to reliably separate rod from cone responses under these conditions.
authors.affiliation: Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK ; Oxford Eye Hospital, Oxford University Hospitals NHS Trust, Oxford OX3 9DU, UK ; Save Sight Institute, University of Sydney, 8 Macquarie St., Sydney, NSW 2000, Australia ; Retinal Unit, Sydney Eye Hospital, 8 Macquarie Street, Sydney, NSW 2000, Australia.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Simunovic
authors.affiliation: Department of Ophthalmology, University of California San Francisco, 533 Parnassus Avenue, San Francisco, CA, USA ; Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK ; Institute of Ophthalmology, University College London, 11-43 Bath Street, London EC1V 9EL, UK.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Moore
authors.affiliation: Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK ; Oxford Eye Hospital, Oxford University Hospitals NHS Trust, Oxford OX3 9DU, UK ; Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK.
authors.forename: Robert E
authors.initials: RE
authors.lastname: MacLaren
keywords: cone perimetry; mesopic perimetry; photopic perimetry; rod perimetry; selective perimetry