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Comparison of central visual sensitivity between monocular and binocular testing in advanced glaucoma patients using imo perimetry
  1. Tomoyuki Kumagai1,
  2. Takuhei Shoji1,
  3. Yuji Yoshikawa1,
  4. Izumi Mine1,
  5. Junji Kanno1,
  6. Hirokazu Ishii1,
  7. Akane Saito1,
  8. Sho Ishikawa1,
  9. Itaru Kimura2,
  10. Kei Shinoda1
  1. 1Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
  2. 2Department of Ophthalmology, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan
  1. Correspondence to Dr Takuhei Shoji, Department of Ophthalmology, Saitama Medical University, Iruma, Saitama 350-0495, Japan; shoojii{at}


Background/Aim This study aimed to compare central visual sensitivity under monocular and binocular conditions in patients with glaucoma using the new imo static perimetry.

Methods Fifty-one consecutive eyes of 51 patients with open-angle glaucoma who were affected with at least one significant point in the central 10° were examined in this cross-sectional study. Monocular and binocular random single-eye tests were performed using the imo perimeter and the Humphrey field analyser (HFA) 24-2 and 10-2 tests. The eyes were assigned to ‘better’ and ‘worse’ categories based on the visual acuity and central visual thresholding. Central visual sensitivity results obtained by monocular, binocular random single-eye tests and binocular simultaneous both eye test were compared.

Results The average mean deviation with the HFA 24-2 was −5.5 (–1.5, –14.6) dB (median, (IQR)) in the better eyes and −18.0 (–12.9, –23.8) dB in the worse eyes. The mean sensitivity in the central 4 points of the visual field (VF) of the worse eyes was lower when measured under the binocular eye condition than under the monocular condition. Conversely, this value of the better eyes was greater when measured under the binocular eye condition than under the monocular condition.

Conclusions The central sensitivity of the better eyes was better and that of the worse eyes poorer with binocular testing than with monocular testing in patients with glaucoma. Although monocular VF testing is still the most straightforward means to monocularly monitor glaucoma at clinical settings, binocular testing, such as provided with imo perimetry, may be a useful clinical tool to predict the effect of VF impairments on a patient’s quality of visual life.

  • physiology
  • glaucoma
  • field of vision

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  • Contributors Involved in design and conduct of study: TK, TS, IK and KS. Data collection: TS, TK, YY, IM, JK, HI, AS and SI. Analysis and interpretation of data: TS and TK. Writing: TS, TK and KS. Critical revision: TS, TK and SK. Approval of the manuscript: TK, TS, YY, IM, JK, HI, AS, SI, IT and KS.

  • Funding This study was supported in part by a Japan Society for the Promotion of Science grant (Kakenhi grant number 19K09976).

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval This cross-sectional study was approved by the Ethics Committee of Saitama Medical University and was conducted in accordance with the tenets of the Declaration of Helsinki.

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

  • Data availability statement Data are available on request. The datasets during and/or analysed during the current study available from the corresponding author on reasonable request.

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