Evaluation of White-on-white Perimetry Using Size I Stimulus Compared with Blue-on-yellow Perimetry

Purpose: The authors compared the visual field results which were taken by white-on-white (W/W) perimetry using a Goldmann size I stimulus with those of blue-on-yellow (B/Y) perimetry, and evaluated the effectiveness of W/W perimetry using size I stimulus. Methods: The study objects were 21 eyes of 21 normal persons (NP), 19 eyes of 12 cases with ocular hypertension (OHT), 42 eyes of 30 cases with large cupping (C/D ratio ≥0.7) but with no visual field defects (LC), 18 eyes of 15 cases with early glaucomatous visual fields (EG). Program 24-2 of the Humphrey Field Analyzer was performed on all subjects using W/W perimetry (sizes I and III) and B/Y perimetry (size V). The authors compared mean sensitivity (MS), probability symbols, abnormal locations and short-term fluctuation (SF) between these four groups. Results: The MS for the EG group was less than that for the NP group in all types of perimetry, but the probability level for W/W perimetry using size I stimulus (p<0.01) was lower than that of B/Y perimetry (p<0.05). Although the EG group had a larger number of probability symbols than the NP group with W/W perimetry (p<0.01), there was no significant difference with B/Y perimetry. The EG group had a larger number of abnormal locations than the NP group in all types of perimetry, but the probability level for W/W perimetry using size I stimulus (p<0.01) was lower than that for B/Y perimetry (p<0.05). The MS for the LC group was less than that for the NP group for all types of perimetry. With regard to the number of probability symbols and abnormal locations, the difference between the NP and LC groups was only statistically significant for W/W perimetry using size I stimulus. Although the SF of the EG group was greater than that of the NP group on W/W perimetry (p<0.01), there was no significant difference on B/Y perimetry. Conclusion: These findings suggest that W/W perimetry, using a size I stimulus, is more sensitive for detecting early glaucomatous visual field damage than B/Y perimetry. Introduction Although blue-on-yellow (B/Y) perimetry is expected to detect early glaucomatous visual field loss prior to white-on-white (W/W) perimetry using a Goldmann size III stimulus, it has also been reported that W/W perimetry, using a size I stimulus, is more sensitive for detecting a slight change in the visual field than the size III stimulus. In this study, we Address for correspondence: Masahiro Osako, Department of Ophthalmology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan 67.p65 11/25/99, 12:36 PM 365 366 M. Takada et al. Table 1. Background of NP, OHT, LC, EG groups Group Cases/eyes Age (years) IOP (mmHg) Mean deviation (dB) NP 21/21 48.6±6.1 15.2±2.4 0.39±0.9 (37~60) (10~20) (-1.65~1.67) OHT 12/19 48.4±5.5 24.6±2.4 0.16±0.92 (41~58) (22~31) (-1.77~2.02) LC 30/42 50.3±5.4 14.3±2.9 -0.11±0.97 (40~58) (9~20) (-2.15~1.82) EG 15/18 47.7±7.8 16.1±4.4 -1.98±0.94 (38~60) (10~26) (-2.8~0.13)