The loss of visual function in glaucoma.

This article reviews innovative techniques for assessing the visual field and for examining glaucoma patients for evidence of visual field progression. The authors discuss the algorithms for assessing change in visual fields used in each of several multicenter studies sponsored by the National Eye Institute. The authors also give a brief review of 2 currently available alternatives to standard automated perimetry.

Using unsupervised learning with variational bayesian mixture of factor analysis to identify patterns of glaucomatous visual field defects.

Purpose: To determine whether an unsupervised machine learning classifier can identify patterns of visual field loss in standard visual fields consistent with typical patterns learned by decades of human experience.

Methods: Standard perimetry thresholds for 52 locations plus age from one eye of each of 156 patients with glaucomatous optic neuropathy (GON) and 189 eyes of healthy subjects were clustered with an unsupervised machine classifier, variational Bayesian mixture of factor analysis (vbMFA).

Results: The vbMFA formed five distinct clusters.

Using machine learning classifiers to identify glaucomatous change earlier in standard visual fields.

Purpose: To compare the ability of several machine learning classifiers to predict development of abnormal fields at follow-up in ocular hypertensive (OHT) eyes that had normal visual fields in baseline examination.

Methods: The visual fields of 114 eyes of 114 patients with OHT with four or more visual field tests with standard automated perimetry over three or more years and for whom stereophotographs were available were assessed. The mean (+/-SD) number of visual field tests was 7.

What does functional testing tell us about optic nerve damage?

Information from different regions of the visual field travels through specific bundles of retinal ganglion cell axons. This visual information is disrupted in patients with glaucoma, and the effects can be seen in measurements of the visual field and optic nerve. Typical shapes and sizes of glaucomatous field defects result from damage to these nerve fiber bundles at the level of the optic disk, and we have identified specific patterns of progression.

Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma.

Purpose: To compare short-wavelength automated perimetry, frequency-doubling technology perimetry, and motion-automated perimetry, each of which assesses different aspects of visual function, in eyes with glaucomatous optic neuropathy and ocular hypertension.

Methods: One hundred thirty-six eyes from 136 subjects were evaluated with all three tests as well as with standard automated perimetry. Fields were not used in the classification of study groups to prevent bias, because the major purpose of the study was to evaluate each field type relative to the others.

Pattern of early visual field loss in HIV-infected patients.

Objective: To determine the topographic pattern of visual field loss, if any, and its relationship to the stage of disease in human immunodeficiency virus-positive patients without infectious retinopathy.

Methods: A total of 151 eyes from 81 alert and cooperative patients with human immunodeficiency virus were evaluated with visual field testing. Results were analyzed relative to the associated underlying nerve fiber layer patterns associated with retinal ganglion cell axons as they traverse the retina to the optic nerve.

Short-wavelength automated perimetry and motion automated perimetry in patients with glaucoma.

Objective: To compare short-wavelength automated perimetry (SWAP), a test favoring the detection of the target by the parvocellular pathways of vision, with motion automated perimetry (MAP), a test favoring detection by the magnocellular pathways, in the same eyes.

Participant: Thirty-three individuals in whom glaucoma was suspected (glaucoma suspects) and 17 patients with primary open-angle glaucoma were compared with 30 age-matched normal control subjects.

Interventions: Short-wavelength automated perimetry was done with the usual protocol (program 24-2).

Asymmetries in the normal short-wavelength visual field: implications for short-wavelength automated perimetry.

Purpose: To quantify short-wavelength sensitivity in normal eyes by hemifield location, eccentricity, and age.

Methods: We measured achromatic and short-wavelength thresholds across visual fields covering a radius of 21 degrees of visual angle in 115 normal eyes in subjects aged 17 to 77 years and out to 30 degrees of eccentricity in an additional 57 eyes in subjects aged 22 to 80 years.

Results: Results indicated significantly greater sensitivity for the inferior visual field compared with the superior field (P = .