The influence of stimulus size and normal database on the detection of visual field defects in automated static threshold perimetry (Humphrey Field Analyzer) was investigated in 82 eyes having a diagnosis of normal, glaucoma suspect, or early glaucoma. Using a mathematically derived 'normal' database, which assumes constantly decreasing threshold sensitivities with increasing eccentricity, the size I stimulus showed significantly greater sensitivity than the size III stimulus for detecting small, shallow scotomata in the central visual field. The use of Statpac, which contains an empirically derived, age-related normal database, increased the sensitivity significantly over that of the size III stimulus (with its mathematical model), and to a degree similar to that of the size I stimulus. The results obtained with the size I stimulus were reproducible and independent of the patient's age. This study suggests a potential role for the size I stimulus in evaluating eyes having or at risk of developing early glaucomatous field loss.
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