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Precis: The agreement between a head-mounted perimeter [GearVision (GV)] and Humphrey field analyzer (HFA) for total threshold sensitivity was a mean difference of -1.9 dB (95% limits of agreement -5 to 1). GV was the preferred perimeter in 68.2% of participants., Purpose: The purpose of this study was to compare reliability indices and threshold sensitivities obtained using a novel, smartphone-based, head-mounted perimeter (GV) with the HFA in normal, glaucoma suspect and glaucoma patients. A secondary objective was to evaluate the subjective experience participants had with both perimeters using a questionnaire., Methods: In a prospective, cross-sectional study; 107 eyes (34 glaucoma, 18 glaucoma suspect, and 55 normal) of 54 participants underwent HFA and GV in random order. The main outcome measure was the agreement of threshold sensitivities using Bland and Altman analysis. Participants also completed a questionnaire about their experience with the devices., Results: Median false-positive response rate for GV was 7% (4% to 12%), while for HFA it was 0% (0% to 6%, P<0.001). Median false-negative response rate was similar for both tests. In all, 84 eyes with reliable HFA and GV results were included in the final analysis. Median threshold sensitivity of all 52 points on HFA was 29.1 dB (26.5 to 30.7 dB) and for GV was 30.6 dB (29.1 to 32.6 dB; P<0.001). Mean difference (95% limits of agreement) in total threshold sensitivity between HFA and GV was -1.9 dB (-5 to 1 dB). The 95% limits of agreement were fairly narrow (-8 to 2 dB) across the 6 Garway-Heath sectors. Most participants preferred to perform GV (68.2%) if required to repeat perimetry compared with HFA (20.6%, P<0.001)., Conclusions: There was fairly good agreement between the threshold sensitivities of GV and HFA. GV was also preferred by most patients and could potentially supplement HFA as a portable or home perimeter., Competing Interests: Disclosure: H.L.R. is a consultant to Santen and Allergan and has received research support from Carl-Zeiss Meditec. The remaining authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Purpose: To compare the visual field (VF) parameters of the new Swedish Interactive Thresholding Algorithm (SITA), SITA Faster (SFR) with that of SITA Standard (SS) on the Humphrey Field Analyzer., Methods: Ninety-seven eyes of 97 subjects (63 glaucoma, 26 glaucoma suspects, and 8 normal eyes) underwent VF examination with SFR and SS strategies on the same day in random order. Agreement in VF parameters between SFR and SS strategies was assessed by Bland and Altman plots. In addition, some subjects underwent a second VF examination with SFR strategy to evaluate its test-retest variability., Results: The median test duration of SS strategy was 6 minutes 14 seconds, whereas SFR was 2 minutes 49 seconds (55% shorter, P<0.001). Median mean deviation (-7.3 vs. -7.6 dB, P=0.73) and VF index (88 vs. 88%, P=0.32) were similar between the 2 strategies, whereas pattern standard deviation was significantly higher (4.8 vs. 4.7 dB, P=0.01) with SS strategy. Overall average threshold sensitivity and Garway-Heath sector-wise threshold sensitivities were similar between the 2 strategies except for the nasal sector where SFR strategy had higher sensitivity (26 vs. 25 dB, P=0.02). Bland-Altman plots showed the mean difference in all VF parameters between the SS and SFR strategies were small (ranging from -1.0 dB for the nasal sector to -0.01 dB for superotemporal sector sensitivity). The test-retest variability of VF parameters with SFR strategy was low., Conclusions: VF parameters with SFR showed good agreement with that of SS strategy. This, combined with low test-retest variability, suggests that SFR can be considered for diagnosis and monitoring of glaucoma.

Purpose: To predict the intereye asymmetry in functional (mean deviation, MD on visual field, VF) and structural (retinal nerve fibre layer, RNFL and ganglion cell complex, GCC thickness on spectral domain optical coherence tomography, SDOCT) measurements in glaucoma using the automated pupillography parameters., Methods: Fifty-nine subjects with a diagnosis of either glaucoma or glaucoma suspect underwent automated pupillography along with VF and SDOCT examinations. Association between pupillography and the absolute intereye difference in MD, RNFL and GCC measurements was evaluated using regression analysis after accounting for the multicollinearity., Results: Univariate regression analysis showed statistically significant associations (p < 0.05) between multiple pupillography parameters and the intereye difference in MD, RNFL and GCC thickness measurements. Multivariate regression with less strongly correlated parameters identified intereye difference in amplitude change (Ac) per cent to be the parameter that best predicted the intereye asymmetry in MD (Intereye asymmetry in MD = 2.20 + 1.33*intereye difference in Ac per cent, R 2  = 0.36), RNFL thickness (3.38 + 3.55*intereye difference in Ac per cent, R 2  = 0.49) and GCC thickness (4.49 + 2.06* intereye difference in Ac per cent, R 2  = 0.41). Ability of intereye Ac per cent difference to predict intereye asymmetry in MD, RNFL and GCC thickness was better in patients with angle closure disease (R 2  = 0.38, 0.79, 0.66, respectively) compared to those with open angles (R 2  = 0.25, 0.15, 0.16, respectively)., Conclusions: Intereye asymmetry in MD, RNFL and GCC thickness measurements was best predicted by the intereye difference in Ac per cent on automated pupillography. The predicting ability was better in patients with angle closure compared to those with open angles., (© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Purpose: To evaluate the sectoral and global structure-structure (vessel density-retinal nerve fiber layer thickness) and structure-function (vessel density-visual sensitivity loss) relationships of peripapillary vessel density measurements on optical coherence tomography angiography in primary open-angle glaucoma and to determine if fractional polynomial (FP) models characterize the relationships better than linear models., Materials and Methods: In a cross-sectional study, structure-structure and structure-function relationships of peripapillary vessel densities were determined in 227 eyes of 143 subjects (63 control and 164 primary open-angle glaucoma eyes) who had undergone standard automated perimetry and optical coherence tomography testing within 6 months of each other, using linear and FP models. FP model evaluates the relationship between the dependent and the best-fitting fractional powers of the independent variable. Strength of relationship was reported as coefficient of determination (R)., Results: R values for structure-structure associations using linear models (0.53 for superotemporal sector, 0.61 for inferotemporal, and 0.53 for average measurements) were significantly less (P<0.05) than that determined using FP models (0.57, 0.65, and 0.55, respectively). R values for structure-function associations using linear models (0.35 for superotemporal vessel density-inferotemporal visual sensitivity loss, 0.49 for inferotemporal vessel density-superotemporal visual sensitivity loss, and 0.39 for average vessel density-average visual sensitivity loss) were significantly less than that determined using FP models (0.43, 0.58, and 0.47, respectively)., Conclusions: The inferotemporal peripapillary vessel density showed the strongest association with the corresponding retinal nerve fiber layer thickness and visual sensitivity loss in the global and sectoral regions studied. The FP models were significantly better than linear models in describing these relationships.

Purpose: To evaluate the diagnostic ability of automated pupillography measurements in glaucoma and study the effect of inter-eye asymmetry in glaucomatous damage on the diagnostic ability., Methods: In an observational, cross-sectional study, 47 glaucoma patients and 42 control subjects underwent automated pupillography using a commercially available device. Diagnostic abilities of the pupillary response measurements were evaluated using area under receiver operating characteristic (ROC) curves (AUC) and sensitivities at fixed specificities. Influence of inter-eye asymmetry in glaucoma [inter-eye mean deviation (MD) difference on visual fields (VF)] on the diagnostic ability of pupillography parameters was evaluated by ROC regression approach., Results: The AUCs of automated pupillography parameters ranged from 0.60 (amplitude score with peripheral blue stimulus) to 0.82 (amplitude score with full field white stimulus, Amp-FF-W). Sensitivity at 95% specificity ranged between 5% (amplitude score with full field blue stimulus) and 45% (amplitude score with full field green stimulus). Inter-eye MD difference significantly affected the diagnostic performance of automated pupillography parameters (p < 0.05). AUCs of Amp-FF-W at inter-eye MD difference of 0 dB, 5 dB, 10 dB and 15 dB were 0.71, 0.80, 0.87 and 0.93, respectively, according to the regression model. The corresponding sensitivities at 95% specificity were 20%, 34%, 50% and 66%, respectively., Conclusions: The diagnostic abilities of even the best automated pupillography parameters were only moderate in glaucoma. The performance of these pupillography measurements in detecting glaucoma significantly increased with greater inter-eye asymmetry in the glaucomatous damage.

Purpose: To evaluate the reliability indices [fixation losses, false negative response rates (FN) and false positive response rates] and threshold sensitivities obtained from glaucoma patients with a Compass perimeter and to compare the same with the Humphrey field analyzer (HFA)., Methods: In a cross-sectional study, 97 eyes of 58 subjects (64 glaucoma and 33 glaucoma suspect eyes) underwent visual field examination with Compass and HFA. Any test with a fixation losses, FN or FP of >20% was considered unreliable. Reliability indices and threshold sensitivities between the 2 instruments were compared and the agreement evaluated using Bland and Altman analysis., Results: In total, 37 tests (38%) with Compass and 17 (18%) with HFA were unreliable. The number of unreliable tests due to high FN (>20%) was significantly more (P=0.005) with Compass (n=27) than HFA (n=3). The mean difference [95% limits of agreement (LoA)] in mean sensitivity between Compass and HFA in the 51 eyes with reliable Compass and HFA results was -0.7 dB (-5.6, 4.3 dB). The point-wise threshold sensitivities with Compass were lower than that with HFA in central and temporal but higher in the nasal field. The 95% LoA ranged from -8 to +5 dB at one of the central points to -20 to +20 dB at one of the peripheral points., Conclusions: The numbers of unreliable tests were higher with Compass compared with HFA. The LoA between Compass and HFA for point-wise threshold sensitivities as well as the global indices were wide, implying that the instruments cannot be used interchangeably.

Purpose: To compare the diagnostic abilities of the vessel densities in optic nerve head (ONH), peripapillary, and macular regions measured using optical coherence tomography angiography (OCTA) in eyes with primary open-angle glaucoma (POAG), and to evaluate the effect of glaucoma severity (based on the mean deviation, MD), optic disc size, and pretreatment intraocular pressure (IOP)., Design: Cross-sectional study., Methods: Seventy-eight eyes of 53 control subjects and 64 eyes of 39 POAG patients underwent OCTA imaging. Area under receiver operating characteristic (ROC) curves (AUC) and sensitivities at fixed specificities of vessel densities in ONH, peripapillary, and macular regions were analyzed. ROC regression was used to evaluate the effect of covariates on the diagnostic abilities., Results: The AUCs of ONH vessel densities ranged between 0.59 (superonasal sector) and 0.73 (average inside disc), peripapillary between 0.70 (nasal, superonasal and temporal) and 0.89 (inferotemporal), and macular between 0.56 (nasal) and 0.64 (temporal). AUC of the average peripapillary vessel density was significantly better than the average inside disc (P = .05) and macular (P = .005) measurement. MD showed a negative association with the AUCs of the vessel densities of all regions. Pretreatment IOP (coefficient: 0.09) showed a significant (P < .05) effect on the AUC of ONH vessel density., Conclusions: Diagnostic ability of the vessel density parameters of OCTA was only moderate. Macular and inside disc densities had significantly lower diagnostic abilities in POAG than the peripapillary density. Diagnostic abilities of vessel densities increased with increasing severity of glaucoma and that of ONH vessel density with higher pretreatment IOPs., (Copyright © 2016 Elsevier Inc. All rights reserved.)