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Clinical science
Effect of fundus tracking on structure–function relationship in glaucoma
  1. Giovanni Montesano1,2,
  2. Luca M Rossetti3,
  3. Allison M McKendrick4,
  4. Andrew Turpin5,
  5. Paolo Fogagnolo3,
  6. Francesco Oddone6,
  7. Paolo Lanzetta7,
  8. Andrea Perdicchi8,
  9. Chris A Johnson9,
  10. Paolo Brusini10,
  11. David F Garway-Heath2,
  12. David P Crabb1
  1. 1 Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
  2. 2 NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
  3. 3 Eye Clinic, University of Milan - ASST Santi Paolo e Carlo, Milan, Italy
  4. 4 Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
  5. 5 School of Computing and Information System, University of Melbourne, Melbourne, Victoria, Australia
  6. 6 Glaucoma Unit, IRCCS Fondazione Bietti, Rome, Italy
  7. 7 Department of Medicine, Ophthalmology, University of Udine, Udine, Italy
  8. 8 Department of Ophthalmology, Sant’Andrea Hospital, University of Rome "La Sapienza", Rome, Italy
  9. 9 Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  10. 10 Department of Ophthalmology, “Città di Udine” Health Center, Udine, Italy
  1. Correspondence to Professor David P Crabb, Division of Optometry & Visual Science, City University, London EC1V 0HB, UK; David.Crabb.1{at}city.ac.uk

Abstract

Aims To investigate the effect of fundus tracking perimetry on structure–function relationship in glaucoma.

Methods Perimetric data were acquired with the Humphrey Field Analyzer (HFA) and the Compass fundus perimeter (CMP, equipped with fundus tracking). We included data from 696 eyes from 360 healthy people and 711 eyes from 434 patients with glaucoma from the original study, for which the circumpapillary retinal nerve fibre layer optical coherence tomography scan (Cp-RNFL) was available. We explored the structure–function relationship using both global indices (mean deviation and average Cp-RNFL thickness loss) and anatomically defined visual field clusters comparing the R2 values from mixed-effect models. We then measured the diagnostic ability of a combined Structure Function Index (SFI) using perimetric data from either perimeter. The comparisons were based on partial receiver operating characteristic curves with a minimum specificity of 75% and their areas under the curve.

Results The R2 for the global structure–function relationship was 0.50 for the CMP and 0.48 for the HFA. When visual field clusters were included in the model, the R2 was 0.29 for CMP and 0.30 for HFA. Overall, the discrimination ability of the SFI was not significantly higher than the Cp-RNFL for either the CMP (p=0.07) or the HFA (p=0.14). However, it was significantly better in eyes with perimetric damage (p<0.001), in which the CMP-SFI performed significantly better than the HFA-SFI (p=0.03).

Conclusions Structure–function relationship is similar between the two perimeters. Fundus tracking might improve discrimination ability with a combined SFI.

Trial registration number ISRCTN13800424.

  • glaucoma
  • imaging
  • psychophysics
  • diagnostic tests/investigation

https://doi.org/10.1136/bjophthalmol-2019-315070

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    Footnotes

    • Twitter @GiovMontesano, @crabblab

    • Contributors GM performed the analyses and wrote the manuscript. LR, AMM, AT, FO, PL, CJ and DFG-H provided the data, contributed to the interpretation of the results and revised the manuscript. PF, PB and DPC contributed to the interpretation of the results and revised the manuscript. DPC supervised the research.

    • Funding The contribution of IRCCS Fondazione Bietti to this work was supported by the Italian Ministry of Health and by Fondazione Roma. CenterVue funded the original data collection but did not support nor requested this additional analysis of the data.

    • Competing interests LR, AMM, AT, PF, FO, PL, PB, CJ, DFG-H and DPC are consultants for CenterVue. AMM, AT and DFG-H received research funding from Heidelberg Engineering.

    • Patient consent for publication Not required.

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

    • Data availability statement Data may be obtained from a third party and are not publicly available. The data are part of the collection sponsored by CenterVue and part of the normative dataset for the Compass perimeter. They belong to CenterVue SpA and are not available for disclosure.

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