STAGING OF FUNCTIONAL DAMAGE IN GLAUCOMA USING FREQUENCY DOUBLING TECHNOLOGY

P. Brusini and C. Tosoni

Department of Ophthalmology - Santa Maria della Misericordia Hospital, Udine, Italy

Frequency Doubling Technology perimetry (FDT) is a new non-conventional visual field testing method, which selectively analyzes the My ganglion cells. The test is fast and easy, but it may be difficult to interpret the results and to classify the severity of damage. Standard Automated Perimetry (SAP) results can be classified into stages of increasing severity according to different methods (analysis of number of depressed points, visual field indices, Glaucoma Staging System, etc.).

We classified 100 FDT tests from patients with both ocular hypertension and chronic glaucoma in four groups (normal tests, early defects, moderate defects, and severe defects). Three different approaches were used: a) clinical analysis of FDT probability map; b) FDT DM and DSM indices, graphed on a 2-axis nomogram; and c) an Abnormality Score, based on both the statistical significance and the spatial location of depressed points. The same patients were also tested with SAP (30-2 Humphrey threshold program), and these results were also classified in four groups using the Glaucoma Staging System (GSS).

All three approaches gave good results in comparison to the GSS classification, but the nomogram (method b) was the easiest and quickest system. Both the clinical evaluation of probability map (method a) and the Abnormality Score (method c) were precise, but it took more time to assess and calculate individual tests.

We believe this nomogram could be useful to differentiate the damage into stages, and to separate the normal tests from abnormal, making the interpretation of FDT results easier.