Healthy Clinical Trial
Official title:
Quantification of Agreement and Variability Characteristics of a Newly Developed Visual Field Algorithm With the Reference Standard: an Observational Study
This study aims to compare two types of visual field test; retinal sensitivity values
obtained with the reference standard Swedish Interactive Thresholding Algorithm (SITA) of the
standard visual field test and with a newly developed test algorithm. The new test is a
visual field test presented on a flat-panel monitor and has two modes: differential light
sensitivity (DLS; equivalent to the standard visual field test) and the Moorfields Motion
Displacement Test (MMDT). DLS sensitivity and DLS measurement variability will be determined
and compared between the SITA algorithm of the standard visual field test and the new visual
field test on the flat-panel monitor. The measurement variability of the MMDT will be
quantified.
The long-term goal is to reduce test variability below that observed in SITA by 20%, whilst
producing comparable measurements (contrast threshold values) for comparable test duration.
Standard Automated Perimetry (SAP) is currently the standard test for screening and
monitoring visual loss owing to glaucoma. This test requires the patient to sit at a machine,
looking at a central light and pressing a button whenever small spots of light appear in the
peripheral vision. Traditionally these spots of light are projected into a bowl (concave
surface), but more recently, computer monitors have been used. Other techniques are also now
available such as the Moorfields Motion Displacement Test, where patients are required to
press a button each time they see a vertical line on the screen wiggle. This test has been
shown to have advantages over SAP, namely, to be tolerant to the effects of cataract and
refractive error.
In clinical settings, the Humphrey Visual Field Analyzer (Zeiss Meditec) is the most used
visual field test in the UK. It employs a SAP strategy coupled with the Swedish Interactive
Thresholding Algorithm (SITA), which is used to derive retinal sensitivity. Visual field
measurements are very variable, requiring many tests over a long period to determine the
extent of vision loss. In addition to the inconvenience caused to patients, the contribution
of these many tests to the financial burden on the NHS is increasing with the growing aging
population. As glaucoma is a chronic disease, patients need lifelong monitoring, requiring
multiple tests and clinic visits. To address these unmet needs, the investigators have
developed a new algorithm that can be used to monitor glaucoma.
The investigators wish to carry out a study, which will allow them to compare agreement
between SITA and a newly developed test algorithm. Measurement variability will be determined
and compared between strategies. The long-term goal is to reduce test variability and the
test time observed in SITA, whilst producing comparable contrast threshold values.
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