Abstract
PURPOSE: The decision to switch between peripheral (24-2) and central (10-2) visual field testing in glaucoma currently rests with clinicians and requires a choice between either intensively sampling central vision or including testing of more peripheral locations (not both). We evaluate an automated approach to incorporate 10-2 locations into the 24-2, without increasing test time or reducing the ability to detect glaucomatous progression at the 24-2 locations. METHODS: We applied our previously published ARREST approach, restricting added locations to a 10-2 pattern (A10). Using computer simulation, the sensitivity of A10 for detecting progression was compared to a ZEST procedure on the 24-2 pattern. Input fields were a synthetic series of 10 visits (6 monthly) of 126 eyes, derived from empirical longitudinal 24-2 data from people with glaucoma. RESULTS: Forty-seven of the 126 progressing visual field series had locations added by A10. The procedures used a similar number of presentations (mean ± SD: A10, 220 ± 27; ZEST, 226 ± 29). Area under the curve (AUC) and survival time for detecting progressing series were similar between methods. A10 allowed visualization of the macular visual field with higher fidelity. CONCLUSIONS: The A10 approach allows automated incorporation of 10-2 locations into the 24-2 pattern that are customized to individuals without increasing test times. TRANSLATIONAL RELEVANCE: The A10 enables higher spatial sampling in individually relevant areas of the 10-2, without neglecting testing of the more peripheral visual field.