Abstract

A new perimetric pattern discrimination test was compared with conventional automated perimetry (Humphrey program 30-2 or Octopus program 32) in glaucoma patients, glaucoma suspects, and control subjects. The new test is based on the rationale that a greater percentage of retinal ganglion cells should be needed to detect a stimulus by its shape, or pattern, than by its brightness. The pattern discrimination stimulus was a patch of nonrandom dots embedded in a surrounding random dot field of the same average density. Pattern discrimination thresholds were measured by changing the degree of regularity, or coherence, of the stimulus dots. The fully coherent target was a static, 1-s duration, 20 × 20-dot checkerboard. Using a criterion-free relative operating characteristic analysis, we estimated the ability of both the pattern discrimination and conventional tests to distinguish the normal data distribution from the suspect and glaucoma distributions. The pattern discrimination test appeared to produce separations greater than conventional perimetry for glaucoma suspects and separations equivalent to conventional perimetry for glaucoma patients.

© 1989 Optical Society of America

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  1. H. A. Quigley, E. Addicks, R. W. Green, “Optic Nerve Damage in Human Glaucoma III. Quantitative Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy,” Arch. Ophthalmol. 100, 135 (1982).
    [CrossRef] [PubMed]
  2. H. B. Barlow, W. R. Levick, M. Yoon, “Responses to Single Quanta of Light in Retinal Ganglion Cells of the Cat,” Vision Res. Suppl. 3, 87 (1971).
    [CrossRef] [PubMed]
  3. E. Kaplan, R. M. Shapley, “The Primate Retina Contains 2 Groups of Ganglion Cells, with High and Low Contrast Sensitivity,” Proc. Natl. Acad. Sci. U.S.A., 83, 2755 (1986).
    [CrossRef] [PubMed]
  4. V. H. Perry, R. Oehler, A. Cowey, “Retinal Ganglion Cells that Project to the Dorsal Lateral Geniculate Nucleus in the Macaque Monkey,” Neurosci. 12, 1101 (1984).
    [CrossRef]
  5. C. D. Phelps, P. Blondeau, B. Carney, “Acuity Perimetry: a Sensitive Test for the Detection of Glaucomatous Optic Nerve Damage,” Doc. Ophthalmol. Proc. Ser. 42, 359 (1984).
    [CrossRef]
  6. L. Frisén, “A Computer-Graphics Visual Field Screener Using High-Pass Spatial Frequency Resolution Targets and Multiple Feedback Devices,” Doc. Ophthalmol. Proc. Ser. 49, 441 (1987).
    [CrossRef]
  7. L. Frisén, “Assessing Criterion Levels and ’Functional Channel Fractions’ in High-Pass Resolution Perimetry,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.
  8. J.-L. Anctil, D. R. Anderson, “Early Foveal Involvement and Generalized Depression of the Visual Field in Glaucoma,” Arch. Ophthalmol. 102, 363 (1984).
    [CrossRef] [PubMed]
  9. B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
    [CrossRef]
  10. B. Drum, M. Breton, R. Massof, D. O’Leary, M. Severns, “Early Glaucoma Detection with Pattern Discrimination Perimetry,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1987), p. 130.
  11. B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).
  12. B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.
  13. B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.
  14. Cohn and Lasley [T. E. Cohn, D. J. Lasley, “Detectability of a Luminance Increment: Effect of Spatial Uncertainty,” J. Opt . Soc. Am. 64, 1715 (1974).] have shown that increasing spatial uncertainty unavoidably increases variability and lowers sensitivity in a similar type of task.
    [CrossRef] [PubMed]
  15. P. Åsman, A. Heijl, “Background Luminance and Detection of Glaucomatous Visual Field Loss,” Invest. Ophthalmol. Vis. Sci. Suppl. 29, 240 (1988).
  16. R. W. Massof, T. C. Emmel, “Criterion-Free Parameter-Free Distribution-Independent Index of Diagnostic Test Performance,” Appl. Opt. 26, 1395 (1987).
    [CrossRef] [PubMed]
  17. R. W. Massof, B. A. Drum, G. S. Rubin, “ROC Analysis Applied to Multivariate Diagnostic Tests,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 102.
  18. D. M. Green, J. A. Swets, Signal Detection Theory and Psychophysics (Krieger, New York, 1974), pp. 45–49.
  19. D. Bamber, “The Area Above the Ordinal Dominance Graph and the Area Below the Receiver Operating Characteristic Graph,” J. Math. Psychol. 12, 387 (1975).
    [CrossRef]
  20. J. A. Hanley, B. J. MacNeil, “The Meaning and Use of the Area Under the Receiver Operating Characteristic (ROC) Curve,” Radiology 143, 29 (1982).
    [PubMed]
  21. Results of the PDP tests were stored on floppy disk on the Horizon computer. Data files were transferred to an IBM-PC/AT compatible computer for analysis via an RS-232 interface using an error-free protocol. Results from the Humphrey perimeter also were transferred to the IBM-PC/AT compatible computer via the RS-232 interface. Results from the Octopus perimeter were entered manually into the computer. All visual field data (PDP and CVF) were transformed to a right-eye format for analysis. PDP coherence thresholds were converted to sensitivities (sensitivity = 100% − threshold) for compatibility with the CVF log sensitivity data. The data were then analyzed using a combination of commercial statistical packages and custom software.
  22. E. Aulhorn, H. Karmeyer, “Frequency Distribution in Early Glaucomatous Visual Field Defects,” Doc. Ophthalmol. Proc. Ser. 14, 75 (1977).
  23. S. P. Nicholas, E. B. Werner, “Location of Early Glaucomatous Visual Field Defects,” Can. J. Ophthalmol. 15, 131 (1980).
    [PubMed]
  24. M. Coughlan, A. I. Friedmann, “The Frequency Distribution of Early Visual Field Defects in Glaucoma,” Doc. Ophthalmol. Proc. Ser. 26, 345 (1981).
    [CrossRef]
  25. A. Heijl, L. Lundqvist, “The Location of Earliest Glaucomatous Visual Field Defects Documented by Automatic Perimetry,” Doc. Ophthalmol. Proc. Ser. 35, 153 (1983).
    [CrossRef]
  26. D. B. Henson, A. J. Hobley, “Frequency Distribution of Early Glaucomatous Visual Field Defects,” Am. J. Optom. Physiol. Opt. 63, 455 (1986).
    [CrossRef] [PubMed]
  27. J. Katz, A. Sommer, “Similarities Between the Visual Fields of Ocular Hypertensive and Normal Eyes,” Arch. Ophthalmol. 104, 1648 (1986).
    [CrossRef] [PubMed]

1988 (1)

P. Åsman, A. Heijl, “Background Luminance and Detection of Glaucomatous Visual Field Loss,” Invest. Ophthalmol. Vis. Sci. Suppl. 29, 240 (1988).

1987 (4)

R. W. Massof, T. C. Emmel, “Criterion-Free Parameter-Free Distribution-Independent Index of Diagnostic Test Performance,” Appl. Opt. 26, 1395 (1987).
[CrossRef] [PubMed]

L. Frisén, “A Computer-Graphics Visual Field Screener Using High-Pass Spatial Frequency Resolution Targets and Multiple Feedback Devices,” Doc. Ophthalmol. Proc. Ser. 49, 441 (1987).
[CrossRef]

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

1986 (3)

E. Kaplan, R. M. Shapley, “The Primate Retina Contains 2 Groups of Ganglion Cells, with High and Low Contrast Sensitivity,” Proc. Natl. Acad. Sci. U.S.A., 83, 2755 (1986).
[CrossRef] [PubMed]

D. B. Henson, A. J. Hobley, “Frequency Distribution of Early Glaucomatous Visual Field Defects,” Am. J. Optom. Physiol. Opt. 63, 455 (1986).
[CrossRef] [PubMed]

J. Katz, A. Sommer, “Similarities Between the Visual Fields of Ocular Hypertensive and Normal Eyes,” Arch. Ophthalmol. 104, 1648 (1986).
[CrossRef] [PubMed]

1984 (3)

V. H. Perry, R. Oehler, A. Cowey, “Retinal Ganglion Cells that Project to the Dorsal Lateral Geniculate Nucleus in the Macaque Monkey,” Neurosci. 12, 1101 (1984).
[CrossRef]

C. D. Phelps, P. Blondeau, B. Carney, “Acuity Perimetry: a Sensitive Test for the Detection of Glaucomatous Optic Nerve Damage,” Doc. Ophthalmol. Proc. Ser. 42, 359 (1984).
[CrossRef]

J.-L. Anctil, D. R. Anderson, “Early Foveal Involvement and Generalized Depression of the Visual Field in Glaucoma,” Arch. Ophthalmol. 102, 363 (1984).
[CrossRef] [PubMed]

1983 (1)

A. Heijl, L. Lundqvist, “The Location of Earliest Glaucomatous Visual Field Defects Documented by Automatic Perimetry,” Doc. Ophthalmol. Proc. Ser. 35, 153 (1983).
[CrossRef]

1982 (2)

H. A. Quigley, E. Addicks, R. W. Green, “Optic Nerve Damage in Human Glaucoma III. Quantitative Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy,” Arch. Ophthalmol. 100, 135 (1982).
[CrossRef] [PubMed]

J. A. Hanley, B. J. MacNeil, “The Meaning and Use of the Area Under the Receiver Operating Characteristic (ROC) Curve,” Radiology 143, 29 (1982).
[PubMed]

1981 (1)

M. Coughlan, A. I. Friedmann, “The Frequency Distribution of Early Visual Field Defects in Glaucoma,” Doc. Ophthalmol. Proc. Ser. 26, 345 (1981).
[CrossRef]

1980 (1)

S. P. Nicholas, E. B. Werner, “Location of Early Glaucomatous Visual Field Defects,” Can. J. Ophthalmol. 15, 131 (1980).
[PubMed]

1977 (1)

E. Aulhorn, H. Karmeyer, “Frequency Distribution in Early Glaucomatous Visual Field Defects,” Doc. Ophthalmol. Proc. Ser. 14, 75 (1977).

1975 (1)

D. Bamber, “The Area Above the Ordinal Dominance Graph and the Area Below the Receiver Operating Characteristic Graph,” J. Math. Psychol. 12, 387 (1975).
[CrossRef]

1974 (1)

Cohn and Lasley [T. E. Cohn, D. J. Lasley, “Detectability of a Luminance Increment: Effect of Spatial Uncertainty,” J. Opt . Soc. Am. 64, 1715 (1974).] have shown that increasing spatial uncertainty unavoidably increases variability and lowers sensitivity in a similar type of task.
[CrossRef] [PubMed]

1971 (1)

H. B. Barlow, W. R. Levick, M. Yoon, “Responses to Single Quanta of Light in Retinal Ganglion Cells of the Cat,” Vision Res. Suppl. 3, 87 (1971).
[CrossRef] [PubMed]

Addicks, E.

H. A. Quigley, E. Addicks, R. W. Green, “Optic Nerve Damage in Human Glaucoma III. Quantitative Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy,” Arch. Ophthalmol. 100, 135 (1982).
[CrossRef] [PubMed]

Anctil, J.-L.

J.-L. Anctil, D. R. Anderson, “Early Foveal Involvement and Generalized Depression of the Visual Field in Glaucoma,” Arch. Ophthalmol. 102, 363 (1984).
[CrossRef] [PubMed]

Anderson, D. R.

J.-L. Anctil, D. R. Anderson, “Early Foveal Involvement and Generalized Depression of the Visual Field in Glaucoma,” Arch. Ophthalmol. 102, 363 (1984).
[CrossRef] [PubMed]

Åsman, P.

P. Åsman, A. Heijl, “Background Luminance and Detection of Glaucomatous Visual Field Loss,” Invest. Ophthalmol. Vis. Sci. Suppl. 29, 240 (1988).

Aulhorn, E.

E. Aulhorn, H. Karmeyer, “Frequency Distribution in Early Glaucomatous Visual Field Defects,” Doc. Ophthalmol. Proc. Ser. 14, 75 (1977).

Bamber, D.

D. Bamber, “The Area Above the Ordinal Dominance Graph and the Area Below the Receiver Operating Characteristic Graph,” J. Math. Psychol. 12, 387 (1975).
[CrossRef]

Barlow, H. B.

H. B. Barlow, W. R. Levick, M. Yoon, “Responses to Single Quanta of Light in Retinal Ganglion Cells of the Cat,” Vision Res. Suppl. 3, 87 (1971).
[CrossRef] [PubMed]

Blondeau, P.

C. D. Phelps, P. Blondeau, B. Carney, “Acuity Perimetry: a Sensitive Test for the Detection of Glaucomatous Optic Nerve Damage,” Doc. Ophthalmol. Proc. Ser. 42, 359 (1984).
[CrossRef]

Breton, M.

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

B. Drum, M. Breton, R. Massof, D. O’Leary, M. Severns, “Early Glaucoma Detection with Pattern Discrimination Perimetry,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1987), p. 130.

Carney, B.

C. D. Phelps, P. Blondeau, B. Carney, “Acuity Perimetry: a Sensitive Test for the Detection of Glaucomatous Optic Nerve Damage,” Doc. Ophthalmol. Proc. Ser. 42, 359 (1984).
[CrossRef]

Cohn, T. E.

Cohn and Lasley [T. E. Cohn, D. J. Lasley, “Detectability of a Luminance Increment: Effect of Spatial Uncertainty,” J. Opt . Soc. Am. 64, 1715 (1974).] have shown that increasing spatial uncertainty unavoidably increases variability and lowers sensitivity in a similar type of task.
[CrossRef] [PubMed]

Coughlan, M.

M. Coughlan, A. I. Friedmann, “The Frequency Distribution of Early Visual Field Defects in Glaucoma,” Doc. Ophthalmol. Proc. Ser. 26, 345 (1981).
[CrossRef]

Cowey, A.

V. H. Perry, R. Oehler, A. Cowey, “Retinal Ganglion Cells that Project to the Dorsal Lateral Geniculate Nucleus in the Macaque Monkey,” Neurosci. 12, 1101 (1984).
[CrossRef]

Drum, B.

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

B. Drum, M. Breton, R. Massof, D. O’Leary, M. Severns, “Early Glaucoma Detection with Pattern Discrimination Perimetry,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1987), p. 130.

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

Drum, B. A.

R. W. Massof, B. A. Drum, G. S. Rubin, “ROC Analysis Applied to Multivariate Diagnostic Tests,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 102.

Emmel, T. C.

Friedmann, A. I.

M. Coughlan, A. I. Friedmann, “The Frequency Distribution of Early Visual Field Defects in Glaucoma,” Doc. Ophthalmol. Proc. Ser. 26, 345 (1981).
[CrossRef]

Frisén, L.

L. Frisén, “A Computer-Graphics Visual Field Screener Using High-Pass Spatial Frequency Resolution Targets and Multiple Feedback Devices,” Doc. Ophthalmol. Proc. Ser. 49, 441 (1987).
[CrossRef]

L. Frisén, “Assessing Criterion Levels and ’Functional Channel Fractions’ in High-Pass Resolution Perimetry,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

Green, D. M.

D. M. Green, J. A. Swets, Signal Detection Theory and Psychophysics (Krieger, New York, 1974), pp. 45–49.

Green, R. W.

H. A. Quigley, E. Addicks, R. W. Green, “Optic Nerve Damage in Human Glaucoma III. Quantitative Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy,” Arch. Ophthalmol. 100, 135 (1982).
[CrossRef] [PubMed]

Hanley, J. A.

J. A. Hanley, B. J. MacNeil, “The Meaning and Use of the Area Under the Receiver Operating Characteristic (ROC) Curve,” Radiology 143, 29 (1982).
[PubMed]

Heijl, A.

P. Åsman, A. Heijl, “Background Luminance and Detection of Glaucomatous Visual Field Loss,” Invest. Ophthalmol. Vis. Sci. Suppl. 29, 240 (1988).

A. Heijl, L. Lundqvist, “The Location of Earliest Glaucomatous Visual Field Defects Documented by Automatic Perimetry,” Doc. Ophthalmol. Proc. Ser. 35, 153 (1983).
[CrossRef]

Henson, D. B.

D. B. Henson, A. J. Hobley, “Frequency Distribution of Early Glaucomatous Visual Field Defects,” Am. J. Optom. Physiol. Opt. 63, 455 (1986).
[CrossRef] [PubMed]

Hobley, A. J.

D. B. Henson, A. J. Hobley, “Frequency Distribution of Early Glaucomatous Visual Field Defects,” Am. J. Optom. Physiol. Opt. 63, 455 (1986).
[CrossRef] [PubMed]

Kaplan, E.

E. Kaplan, R. M. Shapley, “The Primate Retina Contains 2 Groups of Ganglion Cells, with High and Low Contrast Sensitivity,” Proc. Natl. Acad. Sci. U.S.A., 83, 2755 (1986).
[CrossRef] [PubMed]

Karmeyer, H.

E. Aulhorn, H. Karmeyer, “Frequency Distribution in Early Glaucomatous Visual Field Defects,” Doc. Ophthalmol. Proc. Ser. 14, 75 (1977).

Katz, J.

J. Katz, A. Sommer, “Similarities Between the Visual Fields of Ocular Hypertensive and Normal Eyes,” Arch. Ophthalmol. 104, 1648 (1986).
[CrossRef] [PubMed]

Krupin, T.

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

Lasley, D. J.

Cohn and Lasley [T. E. Cohn, D. J. Lasley, “Detectability of a Luminance Increment: Effect of Spatial Uncertainty,” J. Opt . Soc. Am. 64, 1715 (1974).] have shown that increasing spatial uncertainty unavoidably increases variability and lowers sensitivity in a similar type of task.
[CrossRef] [PubMed]

Leight, J.

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

Levick, W. R.

H. B. Barlow, W. R. Levick, M. Yoon, “Responses to Single Quanta of Light in Retinal Ganglion Cells of the Cat,” Vision Res. Suppl. 3, 87 (1971).
[CrossRef] [PubMed]

Lundqvist, L.

A. Heijl, L. Lundqvist, “The Location of Earliest Glaucomatous Visual Field Defects Documented by Automatic Perimetry,” Doc. Ophthalmol. Proc. Ser. 35, 153 (1983).
[CrossRef]

MacNeil, B. J.

J. A. Hanley, B. J. MacNeil, “The Meaning and Use of the Area Under the Receiver Operating Characteristic (ROC) Curve,” Radiology 143, 29 (1982).
[PubMed]

Mangat-Rai, J.

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

Massof, R.

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

B. Drum, M. Breton, R. Massof, D. O’Leary, M. Severns, “Early Glaucoma Detection with Pattern Discrimination Perimetry,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1987), p. 130.

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

Massof, R. W.

R. W. Massof, T. C. Emmel, “Criterion-Free Parameter-Free Distribution-Independent Index of Diagnostic Test Performance,” Appl. Opt. 26, 1395 (1987).
[CrossRef] [PubMed]

R. W. Massof, B. A. Drum, G. S. Rubin, “ROC Analysis Applied to Multivariate Diagnostic Tests,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 102.

Nicholas, S. P.

S. P. Nicholas, E. B. Werner, “Location of Early Glaucomatous Visual Field Defects,” Can. J. Ophthalmol. 15, 131 (1980).
[PubMed]

O’Leary, D.

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

B. Drum, M. Breton, R. Massof, D. O’Leary, M. Severns, “Early Glaucoma Detection with Pattern Discrimination Perimetry,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1987), p. 130.

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

Oehler, R.

V. H. Perry, R. Oehler, A. Cowey, “Retinal Ganglion Cells that Project to the Dorsal Lateral Geniculate Nucleus in the Macaque Monkey,” Neurosci. 12, 1101 (1984).
[CrossRef]

Perry, V. H.

V. H. Perry, R. Oehler, A. Cowey, “Retinal Ganglion Cells that Project to the Dorsal Lateral Geniculate Nucleus in the Macaque Monkey,” Neurosci. 12, 1101 (1984).
[CrossRef]

Phelps, C. D.

C. D. Phelps, P. Blondeau, B. Carney, “Acuity Perimetry: a Sensitive Test for the Detection of Glaucomatous Optic Nerve Damage,” Doc. Ophthalmol. Proc. Ser. 42, 359 (1984).
[CrossRef]

Quigley, H.

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

Quigley, H. A.

H. A. Quigley, E. Addicks, R. W. Green, “Optic Nerve Damage in Human Glaucoma III. Quantitative Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy,” Arch. Ophthalmol. 100, 135 (1982).
[CrossRef] [PubMed]

Rubin, G. S.

R. W. Massof, B. A. Drum, G. S. Rubin, “ROC Analysis Applied to Multivariate Diagnostic Tests,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 102.

Severns, M.

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

B. Drum, M. Breton, R. Massof, D. O’Leary, M. Severns, “Early Glaucoma Detection with Pattern Discrimination Perimetry,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1987), p. 130.

Shapley, R. M.

E. Kaplan, R. M. Shapley, “The Primate Retina Contains 2 Groups of Ganglion Cells, with High and Low Contrast Sensitivity,” Proc. Natl. Acad. Sci. U.S.A., 83, 2755 (1986).
[CrossRef] [PubMed]

Sommer, A.

J. Katz, A. Sommer, “Similarities Between the Visual Fields of Ocular Hypertensive and Normal Eyes,” Arch. Ophthalmol. 104, 1648 (1986).
[CrossRef] [PubMed]

Swets, J. A.

D. M. Green, J. A. Swets, Signal Detection Theory and Psychophysics (Krieger, New York, 1974), pp. 45–49.

Werner, E. B.

S. P. Nicholas, E. B. Werner, “Location of Early Glaucomatous Visual Field Defects,” Can. J. Ophthalmol. 15, 131 (1980).
[PubMed]

Yoon, M.

H. B. Barlow, W. R. Levick, M. Yoon, “Responses to Single Quanta of Light in Retinal Ganglion Cells of the Cat,” Vision Res. Suppl. 3, 87 (1971).
[CrossRef] [PubMed]

Am. J. Optom. Physiol. Opt. (1)

D. B. Henson, A. J. Hobley, “Frequency Distribution of Early Glaucomatous Visual Field Defects,” Am. J. Optom. Physiol. Opt. 63, 455 (1986).
[CrossRef] [PubMed]

Appl. Opt. (1)

Arch. Ophthalmol. (3)

H. A. Quigley, E. Addicks, R. W. Green, “Optic Nerve Damage in Human Glaucoma III. Quantitative Correlation of Nerve Fiber Loss and Visual Field Defect in Glaucoma, Ischemic Neuropathy, Papilledema, and Toxic Neuropathy,” Arch. Ophthalmol. 100, 135 (1982).
[CrossRef] [PubMed]

J.-L. Anctil, D. R. Anderson, “Early Foveal Involvement and Generalized Depression of the Visual Field in Glaucoma,” Arch. Ophthalmol. 102, 363 (1984).
[CrossRef] [PubMed]

J. Katz, A. Sommer, “Similarities Between the Visual Fields of Ocular Hypertensive and Normal Eyes,” Arch. Ophthalmol. 104, 1648 (1986).
[CrossRef] [PubMed]

Can. J. Ophthalmol. (1)

S. P. Nicholas, E. B. Werner, “Location of Early Glaucomatous Visual Field Defects,” Can. J. Ophthalmol. 15, 131 (1980).
[PubMed]

Doc. Ophthalmol. Proc. Ser. (6)

M. Coughlan, A. I. Friedmann, “The Frequency Distribution of Early Visual Field Defects in Glaucoma,” Doc. Ophthalmol. Proc. Ser. 26, 345 (1981).
[CrossRef]

A. Heijl, L. Lundqvist, “The Location of Earliest Glaucomatous Visual Field Defects Documented by Automatic Perimetry,” Doc. Ophthalmol. Proc. Ser. 35, 153 (1983).
[CrossRef]

E. Aulhorn, H. Karmeyer, “Frequency Distribution in Early Glaucomatous Visual Field Defects,” Doc. Ophthalmol. Proc. Ser. 14, 75 (1977).

B. Drum, M. Breton, R. Massof, H. Quigley, T. Krupin, J. Leight, J. Mangat-Rai, D. O’Leary, “Pattern Discrimination Perimetry: a New Concept in Visual Field Testing,” Doc. Ophthalmol. Proc. Ser. 49, 433 (1987).
[CrossRef]

C. D. Phelps, P. Blondeau, B. Carney, “Acuity Perimetry: a Sensitive Test for the Detection of Glaucomatous Optic Nerve Damage,” Doc. Ophthalmol. Proc. Ser. 42, 359 (1984).
[CrossRef]

L. Frisén, “A Computer-Graphics Visual Field Screener Using High-Pass Spatial Frequency Resolution Targets and Multiple Feedback Devices,” Doc. Ophthalmol. Proc. Ser. 49, 441 (1987).
[CrossRef]

Invest. Ophthalmol. Vis. Sci. (1)

P. Åsman, A. Heijl, “Background Luminance and Detection of Glaucomatous Visual Field Loss,” Invest. Ophthalmol. Vis. Sci. Suppl. 29, 240 (1988).

Invest. Ophthalmol. Visual Sci. (1)

B. Drum, R. Massof, D. O’Leary, H. Quigley, M. Breton, T. Krupin, M. Severns, “Pattern Discrimination Test for Glaucoma,” Invest. Ophthalmol. Visual Sci. Suppl. 28, 62 (1987).

J. Math. Psychol. (1)

D. Bamber, “The Area Above the Ordinal Dominance Graph and the Area Below the Receiver Operating Characteristic Graph,” J. Math. Psychol. 12, 387 (1975).
[CrossRef]

J. Opt . Soc. Am. (1)

Cohn and Lasley [T. E. Cohn, D. J. Lasley, “Detectability of a Luminance Increment: Effect of Spatial Uncertainty,” J. Opt . Soc. Am. 64, 1715 (1974).] have shown that increasing spatial uncertainty unavoidably increases variability and lowers sensitivity in a similar type of task.
[CrossRef] [PubMed]

Neurosci. (1)

V. H. Perry, R. Oehler, A. Cowey, “Retinal Ganglion Cells that Project to the Dorsal Lateral Geniculate Nucleus in the Macaque Monkey,” Neurosci. 12, 1101 (1984).
[CrossRef]

Proc. Natl. Acad. Sci. U.S.A. (1)

E. Kaplan, R. M. Shapley, “The Primate Retina Contains 2 Groups of Ganglion Cells, with High and Low Contrast Sensitivity,” Proc. Natl. Acad. Sci. U.S.A., 83, 2755 (1986).
[CrossRef] [PubMed]

Radiology (1)

J. A. Hanley, B. J. MacNeil, “The Meaning and Use of the Area Under the Receiver Operating Characteristic (ROC) Curve,” Radiology 143, 29 (1982).
[PubMed]

Vision Res. (1)

H. B. Barlow, W. R. Levick, M. Yoon, “Responses to Single Quanta of Light in Retinal Ganglion Cells of the Cat,” Vision Res. Suppl. 3, 87 (1971).
[CrossRef] [PubMed]

Other (7)

L. Frisén, “Assessing Criterion Levels and ’Functional Channel Fractions’ in High-Pass Resolution Perimetry,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

B. Drum, M. Breton, R. Massof, D. O’Leary, M. Severns, “Early Glaucoma Detection with Pattern Discrimination Perimetry,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1987), p. 130.

Results of the PDP tests were stored on floppy disk on the Horizon computer. Data files were transferred to an IBM-PC/AT compatible computer for analysis via an RS-232 interface using an error-free protocol. Results from the Humphrey perimeter also were transferred to the IBM-PC/AT compatible computer via the RS-232 interface. Results from the Octopus perimeter were entered manually into the computer. All visual field data (PDP and CVF) were transformed to a right-eye format for analysis. PDP coherence thresholds were converted to sensitivities (sensitivity = 100% − threshold) for compatibility with the CVF log sensitivity data. The data were then analyzed using a combination of commercial statistical packages and custom software.

R. W. Massof, B. A. Drum, G. S. Rubin, “ROC Analysis Applied to Multivariate Diagnostic Tests,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 102.

D. M. Green, J. A. Swets, Signal Detection Theory and Psychophysics (Krieger, New York, 1974), pp. 45–49.

B. Drum, M. Severns, D. O’Leary, R. Massof, M. Breton, H. Quigley, T. Krupin, “Pattern Discrimination Perimetry and Conventional Perimetry in Early Glaucoma Detection,” in Technical Digest of Topical Meeting on Noninvasive Assessment of the Visual System (Optical Society of America, Washington, DC, 1988), p. 172.

B. Drum, M. Severns, D. O’Leary, R. Massof, H. Quigley, M. Breton, T. Krupin, “Pattern Discrimination and Light Detection Test Different Types of Glaucomatous Damage,” in Proceedings, Eighth IPS Symposium, E. Greve, A. Heijl, Eds. (Kugler, Amsterdam, 1989), in press.

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Figures (8)

Fig. 1
Fig. 1

Stimulus map for Humphrey program 30-2 and Octopus program 32. Positions tested with the pattern discrimination perimeter are enclosed by the large octagonal box. Positions marked by large symbols are tested twice per session. The fixation point is indicated by the central cross. Positions tested during the first half of the session are within the dashed square, and positions tested during the second half of the session are outside the dashed square.

Fig. 2
Fig. 2

20 × 20-pixel stimuli decreasing in spatial coherence from left to right, embedded in random dot surrounds. The white–black dot ratio is 1/1 for both stimuli and surrounds. Spatial coherence is indicated below each stimulus.

Fig. 3
Fig. 3

Mean sensitivity vs age for normal control subjects. Each data symbol is the average sensitivity for all sixty-eight test positions. Circles indicate conventional visual field data and squares indicate pattern discrimination data. Solid lines are least-squares regressions. The log luminance sensitivity and coherence sensitivity scales are normalized by equating the mean residual errors from the regressions.

Fig. 4
Fig. 4

Mean coherence sensitivity vs mean log luminance sensitivity for (A) normal control subjects, (B) glaucoma suspects, and (C) glaucoma patients. Each small data symbol is the average sensitivity over all sixty-eight test positions for one subject. The three large data symbols indicate group means. The log luminance sensitivity and coherence sensitivity scales are normalized as in Fig. 3. The horizontal and vertical dashed lines intersect at the group mean sensitivities of the control subject sample.

Fig. 5
Fig. 5

Point-by-point discrimination probabilities (Pd) between patient and normal threshold distributions. For each position, the area of the black square is proportional to Pd. Left panels show PDP data and right panels show CVF data. Top panels show comparisons between glaucoma patients and normal subjects, and the bottom panels show comparisons between glaucoma suspects and normal subjects. Shaded ovals show the blind spot location.

Fig. 6
Fig. 6

PDP vs CVF scatterplot of the Pd values in Fig. 5. Open circles are glaucoma suspect data and filled circles are glaucoma patient data. Points above the diagonal line indicate that the PDP test discriminated between normal and patient distributions better than the CVF test.

Fig. 7
Fig. 7

Composite Pd estimates for comparisons of normals and glaucoma suspects (left) and normals and glaucoma patients (right), obtained by averaging sensitivity measurements weighted by individual position signal-to-noise ratios and performing an ROC analysis on the weighted averages. Error bars indicate 95% confidence intervals, computed assuming a binomial distribution.

Fig. 8
Fig. 8

Composite Pd estimates for comparisons of normals and glaucoma suspects (open symbols) and normals and glaucoma patients (filled symbols), obtained by averaging sensitivity measurements for each eccentricity, weighted by individual position signalto-noise ratios, and performing an ROC analysis on the weighted averages.

Tables (1)

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Table I Patient Sample

Equations (1)

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threshold  =   ( C n 1 + 2 C p + C n 2 ) / 4 ,

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