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Visual field indices and patterns of visual field deficits in mesopic and dark-adapted two-colour fundus-controlled perimetry in macular diseases
  1. Maximilian Pfau1,
  2. Moritz Lindner1,2,
  3. Julia S Steinberg1,
  4. Sarah Thiele1,
  5. Christian K Brinkmann1,
  6. Monika Fleckenstein1,
  7. Frank G Holz1,
  8. Steffen Schmitz-Valckenberg1
  1. 1Department of Ophthalmology, University of Bonn, Bonn, Germany
  2. 2The Nuffield Laboratory of Ophthalmology, Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
  1. Correspondence to Professor Steffen Schmitz-Valckenberg, Department of Ophthalmology, University of Bonn, 53127 Bonn, Germany; steffen.schmitz-valckenberg{at}ukbonn.de

Abstract

Background/Aims To analyse the retest reliability of visual field indices and to describe patterns of visual field deficits in mesopic and dark-adapted two-colour fundus-controlled perimetry (FCP) in macular diseases.

Methods Seventy-seven eyes (30 eyes with macular diseases and 47 normal eyes) underwent duplicate mesopic and dark-adapted two-colour FCP (Scotopic Macular Integrity Assessment, CenterVue). Non-weighted (mean defect, loss variance), variability-weighted (mean deviation, pattern standard deviation (PSD)) and graphical (cumulative defect (Bebie) curves) indices were computed. Reproducibility (coefficient of repeatability, CoR) of these indices was assessed. Cluster analysis was carried out to identify patterns of visual field deficits.

Results The intrasession reproducibility was lower for the mean defect as compared with the mean deviation (CoR (dB) 2.67 vs 2.57 for mesopic, 1.71 vs 1.45 for dark-adapted cyan, 1.94 vs 1.87 for dark-adapted red testing) and lower for the square-root loss variance as compared with the PSD (CoR (dB) 1.48 vs 1.34, 0.77 vs 0.65, 1.23 vs 1.03). Hierarchical cluster analysis of the indices disclosed six patterns of visual field deficits (approximately unbiased P value>0.95) with varying degrees of global versus focal defect and rod versus cone dysfunction. These were also reflected by the cumulative defect curves.

Conclusion FCP with mesopic and dark-adapted two-colour testing allows for reproducible assessment of different types of retinal sensitivity, whereby mean deviation and PSD exhibited the better retest reliability of the tested indices. Distinct patterns of retinal dysfunction can be identified using this setup, reflecting variable degrees of rod and cone dysfunction in different macular diseases. Dark-adapted two-colour FCP provides additional diagnostic information and allows for refined structure–function correlation in macular diseases.

  • macula
  • psychophysics
  • retina
  • diagnostic tests/investigation
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Footnotes

  • Contributors Conception/design of the study: MP, ML, MF, FGH, SS-V. Data acquisition: MP, ML, JSS, ST, CKB. Data analysis: MP, ML, JSS, ST. Data interpretation: MP, ML, MF, FGH, SS-V. Drafting the manuscript: MP, ML, SS-V. Revising the manuscript critically for important intellectual content: MP, ML, JSS, ST, CKB, MF, FGH, SS-V. Final approval of the version to be published: MP, ML, JSS, ST, CKB, MF, FGH, SS-V. Agreement to be accountable for all aspects of the work: MP, ML, JSS, ST, CKB, MF, FGH, SS-V.

  • Funding This study was supported by the BONFOR GEROK Program of the Faculty of Medicine, University of Bonn, Grant No O-137.0022 and O-137.0025 to MP, Grant No O-137.0020 to ML and by the German Research Foundation (DFG), Grant No 658/4-1 and 658/4-2 to MF, Grant No 2846/1-1 to ML. Financial Support: CenterVue SpA, Padova, Italy has provided research material (S-MAIA) for the conduct of this study.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the Institutional Review Board of the University of Bonn (Ethics Approval ID: 191/16).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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