Big city excitement and small town charm make Portland, Oregon, known as “the City of Roses”, one of the favorite destinations in the West. Situated approximately 70 miles from the Pacific in a magnificent setting between the sparkling waters of the Columbia and Willamette Rivers, Portland is also known as “Bridgetown”, due to it’s numerous spans that cross the rivers. Portland is just a short distance from Willamette valley wineries, skiing at Timberline Lodge and all of the excitement and beauty of Oregon’s spectacular ocean beaches. In the city, Portland’s historic old town, galleries and museums, Saturday Market, and theatre companies will keep visitors busy for weeks!

Nightlife in Portland is excellent and varied, including the world class performances of the internationally-known Oregon Symphony. Performing arts in the area offer ballet, Shakespeare, Broadway musicals, modern dance and much more. Oregon Zoo concerts are a summer treat, with music for all kinds of listeners. Famous for it’s local microbrews, Portland has many local pubs and brewhouses, where tasting local microbrews is considered a fine way to spend an evening.

A splendid location, relaxed respectability, and an urban lifestyle that is unsurpassed for its livability makes Portland a city to remember. The 2006 International Perimetry Society Visual Field Symposium is sponsored by:

table of contents

symposium sponsors 2 welcome to Portland 3 IPS lecture 4 committees and honorary members 5 meeting information 6 social program 7 accompanying persons’ program 12

scientific program 13 abstracts 19

map of downtown Portland 47 program at a glance 48 and

2 Dear IPS members, accompanying persons and guests:

As co-hosts for the 17th Visual Field Symposium of the International Perimetric Society (IPS), we are most pleased to welcome you to Portland, Oregon. Those of us who have attended all or most of the IPS meetings are delighted that it has continued to thrive for more than 30 years, and that the quality of the presentations have improved with each meeting. This year, it appears that the scientific and social programs will augment welcome the grand tradition, quality and integrity of the IPS. We hope that you will enjoy all of the components that this meeting has to offer.

We are delighted that our featured speaker for the IPS Lecture is Dr. Lars Frisén from Göteburg, Sweden. His presentation is entitled “Reclaim the Periphery”.

In addition to the scientific and social programs, we will have exhibit booths and featured presentations for you to enjoy from our Major Sponsors (Allergan, Pfizer, WelchAllyn, Carl Zeiss Meditec, Devers Eye Institute, Heidelberg Engineering, Haag-Streit). Santen and Oculus are also IPS sponsors. We are most grateful to all of our sponsors for their support and cooperation in the planning and implementation of this meeting. These features will add tremendously to the quality and content of the meeting.

We are also quite grateful to Dr. Claude Burgoyne for organizing a most notable symposium on ophthalmic imaging. It will undoubtedly be a highlight of the IPS, and hopefully will bind the study of perimetry and imaging for future IPS meetings!

Please take some time to enjoy the ambience and atmosphere of Portland and its surrounding area. Do not hesitate to ask us about places of interest and related information. We sincerely hope that you will find this meeting to be a memorable one, that you will learn some new information, and (most of all) that you have a fantastic visit.

On behalf of the IPS, the IPS board, and the IPS members, we welcome you to Portland, Oregon !!

With our best wishes for a wonderful IPS,

Chris A. Johnson, PhD Shaban Demirel, BScOptom, PhD IPS lecture LARS FRISEN:´ “RECLAIM THE PERIPHERY”

The IPS lecture will be presented by Lars Frisén. Dr. Frisén was born, raised

and educated in Göteborg, Sweden including a M.D. and Ph.D. from Univer-

sity of Göteborg. Following a fellowship in clinical neuro-oph-

thalmology with W. F. Hoyt at the University of California,

San Francisco, he became Docent of Clinical Neuro-Ophthal-

mology at the University of Göteborg, a position he held for

over 25 years. During this time, he published over 130 scien-

MOUNT HOOD tific papers, mostly dealing with clinical measurements of vision and vari- Mt. Hood, the tallest of Oregon’s ous aspects of defective vision. His monograph, “Clinical Tests of Vision” is Cascade peaks, stands watch over the awe-inspiring Columbia River a classic in clinical vision research. Dr. Frisén is a founding member of the Gorge from a height of 11,239 ft. The often-photographed glacier- International Perimetric Society, the European Society of Neuro-Ophthalmol- glazed peak is home to year-round skiing and snowboarding. Run-off ogy and the International Society of Neuro-Ophthalmology. He is a pioneer from its volcanic slopes enriches soil in the valleys below, which in investigative perimetry, having developed a variety of useful clinical tests are famous for their production of pears, peaches, cherries, apricots including high-pass resolution perimetry (ring test) and rarebit perimetry. His and apples. talk will be entitled “Reclaim the Periphery!”

4 committees and honorary members

Executive Committee Honorary Members of the IPS President: Michael Wall, MD, Iowa City, USA Prof. Stephen Drance Vice President: Aiko Iwase, MD, Gifu, JAPAN Prof. Jay Enoch Vice President: Chris Johnson, PhD, Portland, OR, USA Prof. Franz Fankhauser Secretary: David Henson, PhD. Manchester, England, UK Prof. Erik Greve Treasurer: Ulrich Schiefer, MD, Tübingen, GERMANY Prof. Yoshi Kitazawa

In Memoriam Honorary Members of the IPS Program Committee Prof. Elfriede Aulhorn Shaban Demirel, BScOptom, PhD, Portland, OR, USA Prof. Alan Friedmann PIONEER COURTHOUSE SQUARE David Henson, PhD, Manchester, England, UK Prof. Hans Goldmann Located in the heart of downtown Chris Johnson, PhD, Portland, OR, USA Portland, Pioneer Courthouse Prof. Heinrich Harms Square is affectionately known as Richard Mills, MD, Seattle, WA, USA Prof. Haratuke Matsuo the City’s “living room.” With more Michael Wall, MD, Iowa City, USA Prof. Mario Zingirian than 21,000 people passing by the Square each day, and thousands more visiting the Square directly, Co-Hosts it is the single most visited site in Oregon’s most visited city. Chris Johnson, PhD, Portland, OR, USA Shaban Demirel, BScOptom, PhD, Portland, OR, USA

BENSON BUBBLERS Simon Benson was a turn-of-the-century lumber baron, philanthropist and teetotaller. To provide fresh drinking water downtown - and discour- age his workers from drinking alcohol in the middle of the day - Benson commissioned 20 elegant freshwater drinking fountains, now known as the Benson Bubblers. Beer consumption in the city reportedly decreased 25 percent after the fountains were installed, and the water fountains still bubble invitingly on Portland’s downtown streets. 5 meeting info IPS INTERNATIONAL PERIMETRIC SOCIETY venue registration desk The aim of the IPS is “To promote the study The Portland DoubleTree Hotel & Executive The Registration Desk for the meeting is located in the of normal and abnormal visual function in the Meeting Center lobby of the DoubleTree hotel. Registration Desk Hours: entire visual field, and to ensure and facilitate Portland – Lloyd Center July 11 1:00 pm – 6:30 pm the cooperation and friendship of scientists of 1000 N.E. Multnomah different countries working and interested in July 12 7:30 am – 6:00 pm Portland, OR 97232 USA this discipline.” Founded in 1974, the society Ph: 503 331-4903 July 13 7:30 am – 1:30 pm meets bi-annually. Previous Symposia have met Fax: 503 249 3137 July 14 7:30 am - 6:00 pm in the following locations: www.portlandlloydcenter.doubletree.com 1974: Marseiles, Franch 1976: Tübingen, Germany registration name badge 1978: Tokyo, Japan 1980: Bristok, UK On-Site registration fees are: All registered attendees will receive a name badge. 1982: Sacramento, CA, USA IPS Members $450 Please wear the badge for all meeting activities. 1984: Santa Marguerita Ligure, Italy Non Members $550 1986: Amsterdam, The Netherlands Residents/Fellows $350 1988: Vancouver, Canada Accompanying persons $350 Participation in any event cannot be guaranteed for those 1990: Malmö, Sweden who have not pre-registered. 1992: Kyoto, Japan Registration fee includes: 1994: Washington, D.C.,USA Welcome Reception The meeting place for all off-site events is the lobby of the 1996: Würzburg, Germany Breakfasts and lunches DoubleTree Hotel. 1998: Gardone Riviera, Italy Columbia River Gorge Tour 2000: Halifax, Canada IPS Banquet 2002: Stratford upon Avon, UK 2004: Barcelona, Spain 2006: Portland, OR, USA

6 social program

PORTLANDIA is a sculpture by Raymond Kaskey located above the entrance of Michael Graves’ Portland Building. It is notable for being the second largest copper repoussé statue in the United States after the Statue of Liberty. Installed in September 1985 after being floated down the Willamette River on a barge, the statue is based on the design of the city seal. It depicts a woman in classical clothes with a trident reaching down with right hand to greet visitors to the building.

OREGON’S WINE COUNTRY Friendly, accessible winemakers. Small production, handcrafted wines. Rolling wine country that invites you to sit down, take a sip and stay for awhile. Oregon’s location along the 45th parallel, as well as its maritime weather, make Oregon ideally suit- ed to grow a broad range of wine grapes. Pinot Noir, Chardonnay, Merlot, and Cabernet Sauvignon are just a few of the 40 varietals of wine grapes grown throughout the state.

7 TUESDAY, JULY 11TH 4:00P DRESS: BUSINESS CASUAL FEE: INCLUDED lab tour Discoveries in Sight

Before the IPS Opening Reception on Tuesday, July 11, 2006, a brief tour of the Discoveries in Sight Research Labs will be offered. Discoveries in Sight has a number of studies (both human and animal) devoted to glaucoma and other ocular and neurologic disorders. The facilities include many unique approaches to the study of structural and functional properties of the visual system. Located just 4-5 blocks from the DoubleTree Hotel, we will walk or take a quick ride on MAX to reach the facility. We will have you back at the Hotel with ample time to prepare for the Welcome Reception. Please let us know when you collect your registration materials if you are interested in attending the tour. We will meet in the lobby of the Hotel at 4:00 pm.

Discoveries in Sight TUESDAY, JULY 11TH 7:00P – 10:00P DRESS: BUSINESS CASUAL FEE: INCLUDED opening reception Pittock Mansion

Buses will depart at 6:30 and 7:00 from the DoubleTree Hotel for the Pittock Mansion where we will enjoy an evening of music, heavy hors d’oeuvres and assorted beverages, hosted by Devers Eye Institute of Portland.

Henry Pittock journeyed west on a wagon train to Oregon in 1853 at the age of 19. He began work- ing for the Oregonian newspaper, taking ownership in 1860. The same year, he married 15 year-old Georgiana. Together they planned their home, which they started building in 1909. Completed five years later, it boasted several stunningly progressive features including a central vacuum system, intercoms, and indirect lighting. The final estate included the mansion, a three-car garage, a green- house, and the Italianate gate lodge servants’ residence, all situated on 46 acres of land almost 1,000 feet above downtown Portland.

We hope you will enjoy greeting old friends and meeting new ones within this lovely mansion as you look down upon the city of Portland, with the majestic Mt. Hood in the distance.

Pittock Mansion THURSDAY, JULY 13TH 1:15P – 4:30P DRESS: CASUAL FEE: INCLUDED excursion Columbia River Gorge

We will board small motor coaches for an outing in the Columbia River Gorge National Scenic Area. Box lunches are provided and can be enjoyed as we travel along the western portion of this 80-mile long can- yon formed by the largest flood known to geologists. We will have an opportunity to walk to the bridge suspended over the lower part of Multnomah Falls, the second highest year-round water falls in the United States.

THURSDAY, JULY 13TH 6:00P – 10:30P DRESS: BUSINESS CASUAL FEE: $65 Ann Hampton Callaway dinner and concert

After boarding motor coaches, we will have a short, scenic drive to the campus of Lewis and Clark College, where we will enjoy a meal featuring Pacific Northwest specialties, courtesy of Santen.

The college, set in 137 deeply wooded acres in Portland’s southwest hills, provides a perfect venue for the music of Ann Hampton Callaway. Ms. Callaway is hailed by many as one of the finest singer/ songwriters in present-day America. She will delight us with her versatile, often sultry jazz selections.

Following her performance, we will have an opportunity to meet Ms. Callaway over dessert and coffee/wine prior to reboarding the buses for our return to the Hotel.

Multnomah Falls FRIDAY, JULY 14TH 6:30P – 11:00P DRESS: BUSINESS ATTIRE FEE: INCLUDED banquet with traditional national singing Doubletree Hotel Pacific Northwest Ballroom

Our traditional gala dinner will be held in the Pacific Northwest Ballroom at the DoubleTree Hotel. Following our meal we will enjoy singing from each country’s attendees. Special appearances will be made by the Kurt Wall/Chris Johnson piano duo, and by the band Rule 62.

THURSDAY, JULY 13TH 6:00P – 10:30P DRESS: BUSINESS CASUAL FEE: $65

Ann Hampton Callaway dinner and concert MICROBREW In short, Portland is “Beervana.” After boarding motor coaches, we will have a short, scenic drive to the campus of Lewis and Clark And, yes, to beer lovers in search College, where we will enjoy a meal featuring Pacific Northwest specialties, courtesy of Santen. of the finest configurations of the world’s classic beer styles – all in The college, set in 137 deeply wooded acres in Portland’s southwest hills, provides a perfect venue for one place, all freshly brewed, all on the music of Ann Hampton Callaway. Ms. Callaway is hailed by many as one of the finest singer/ tap no more than 10 or 15 minutes songwriters in present-day America. She will delight us with her versatile, often sultry jazz selections. away from any spot in the city – Portland indeed is “Brewtopia.” Following her performance, we will have an opportunity to meet Ms. Callaway over dessert and coffee/wine prior to reboarding the buses for our return to the Hotel. In fact, with 23 breweries in the city limits and 34 breweries in the metro area, Portland now has more breweries than Munich, that Bavarian burg once regarded as the world’s beer capital.

MAX LIGHT RAIL Portland’s award winning mass transit system is one of the most extensive and advanced in the U.S. The transit system includes buses, streetcars, historic trollies and the MAX, an urban light rail line. There’s also a downtown transit mall and Fareless Square, the downtown free-ride zone. It’s fun to take a relaxing ride on the MAX train and watch the Portland world slide by. 11 accompanying persons’ program

WEDNESDAY, JULY 12TH 9:15A – 12:30P FEE: $30 Woodburn Company Stores

Located just 25 minutes south of Portland, this outlet mall boasts more than 80 name-brand stores. We’ll arrive as the stores open. Whether you shop or browse, there is something for everyone here!

FRIDAY, JULY 14TH 9:00A – 3:00P FEE: $45 Cannon Beach

Aboard a small motor coach, we will travel 75 miles west of Portland to Cannon Beach, a quaint coastal Haystack Rock, Cannon Beach village, surrounded by spectacular natural beauty. A walk along the sandy beach or a stroll through the unique shops will provide a real taste of the Oregon coast. You will be free to make your own lunch arrangements there.

SATURDAY, JULY 15TH 11:30A – 6:00P DRESS: BRING SWIMSUIT OR WEAR UNDER CLOTHING COST: $100 post conference trip white water rafting

We’ll board the motor coach with our box lunch for a beautiful 75-minute ride to the launch site on the White Salmon River. Dressing rooms are provided to change into the wet suits that will be supplied. The White Salmon River is a two-hour adrenaline rush through a picturesque canyon. More than a leisurely float, it’s an exhilarating progression of class two, three, and four rapids, interspersed with quiet pools and delicate waterfalls.

We recommend you bring dry, warm clothing for the trip back to the Hotel.

White Water Rafing, White Salmon River scientific program

INTERNATIONAL ROSE TEST GARDEN Offering a spectacular view of the “City of Roses,” the International Rose Test Garden in Washington Park is one of the largest and oldest rose test gardens in the country. The Rose Garden Gift Shop (adjacent to the rose test garden) offers many rose-related items.

PEARL DISTRICT Historic industrial buildings have been transformed into unique retail storefronts, restaurants, galleries, lofts and townhouses in SATURDAY, JULY 15TH 11:30A – 6:00P DRESS: BRING SWIMSUIT OR WEAR UNDER CLOTHING COST: $100 Portland’s premier shopping dis- trict. The Pearl District is the des- post conference trip white water rafting tination for creative cuisine, home furnishings, art and one-of-a-kind boutiques. Take a break from tour- ing and shopping to relax at one of our picturesque sidewalk cafes. Or enjoy the fountains in Jamison Square.

13 scientific program sessions 1 + 2 WEDNESDAY, JULY 12, 2006

S E S SION 1: Clinical Perimetry I S E S SION 2 : New Perimetry Techniques Moderators: Ron Harwerth and Uli Schiefer Moderators: Chris Johnson and Pam Sample

7:30 – 8:00 Breakfast and Sponsor presentation – Heidelberg Engineering 10:00 – 10:15 A Perimetric Re-Test Algorithm That Is Significantly More Accurate Than Current Procedures 8:00 – 8:15 Visual Performance Test: Results In Hemiopic Defects And In Follow-Up A Turpin, AM McKendrick, D Jankovic Of Compensational Rehabilitation Training F Dannheim, D Verlohr 10:15 – 10:30 A New Approach To Automated Kinetic Perimetry S Hashimoto, C Matsumoto, H Nomoto, E Arimura, S Takada, S Okuyama, 8:15 – 8:30 Evaluation Of Relative Afferent Pupillary Defect In Patients With Homonymous Visual Y Shimomura Field Defects Due To Cerebrovascular Lesions In The Posterior And Middle Cerebral Artery Territories 10:30 – 10:35 Pupil Perimetry In Glaucoma E Papageorgiou, G Hardiess, HA Mallot, B Wilhelm, F Schaeffel, H Wiethoelter, F Maeda, K Tanzawa, T Yoneda, K Kani, A Tabuchi, S Fukushima, S Inakagata, LF Ticini, R Vonthein, HO Karnath, U Schiefer S Ohkubo, K Sugiyama (Poster)

8:30 – 8:45 Visual Field Abnormalities 10 Years After Optic Neuritis: Experience In The Optic Neuritis 10:35 – 10:50 Multifocal Dichoptic Pupillography In Glaucoma Treatment Trial (ONTT) AC James, T Maddess, XL Goh JL Keltner, CA Johnson, KE Cello, RL Gal, AD Kalajian, C Kollman, RW Beck 10:50 – 11:05 The Effect Of Stimulus Orientation, Learning And Central Refraction On A New 8:45 – 8:50 Clinical Follow-Up Return Rates Among Those Screening Positively For Sight-Threatening Multi-Location Motion Displacement Test For The Detection Of Glaucoma Disease In Bexar County, TX GM Verdon-Roe, MC Westcott, R Moosavi, D Gore, AC Viswanathan, FW Fitzke, Y Trigo, J Hendricks, H Koenig, WE Sponsel (Poster) DF Garway-Heath

8:50 – 9:05 Use Of The Size I Test Object For Subtle Optic Neuropathies and Macular Pathology 11:05 – 11:10 Pulsar Perimetry In The Detection Of Early Glaucomatous Visual Field Loss SA Newman ML Salvetat, M Zeppieri, C Tosoni, L Parisi, V Bais, M Felletti, I Bignucolo, and P Brusini (Poster) sessions 1 + 2 9:05 – 9:20 The Role Of Perimetry In Assessing The Ophthalmologic Safety Of Drugs: The Pregabalin Experience 11:10 – 11:25 Characteristics Of The Normal Values For Flicker Perimetry With The Octopus 300 Perimeter MG Brigell S Okuyama, C Matsumoto, S Takada, S Hashimoto, E Arimura, Y Shimomura 9:20 – 9:25 Central Mean Sensitivity And Non-Penetrating Trabeculectomy R Inoue, A Kozaki, T Inoue, Y Inoue (Poster) 11:25 – 11:55 Sponsor presentation - Haag-Streit

9:25 – 9:40 Patho-Physiology Of Nasal Myopic Super-Traction & Possible Related Complications 11:55 – 1:30 Lunch JM Enoch, JB Crawford, EL Howes, SS Choi, D Ling, J Lee, K Laverty

9:40 – 10:00 Coffee, Posters and Exhibits scientific program program scientific

14 scientific program sessions 3 + 4 WEDNESDAY, JULY 12, 2006

1:30 – 2:30 IPS LECTURE: LARS FRISEN - “RECLAIM THE PERIPHERY!”

S E S SION 3 : Optic Nerve Head and Nerve Fiber Imaging S E S SION 4 : Innovative Topics Moderators: Linda Zangwill and John Keltner Moderators: Paul Artes and Shaban Demirel

2:30 – 2:45 Age-Related Losses Of Retinal Ganglion Cells And Nerve Fiber Layer Thickness 4:25 – 4:40 To What Extent Does Size And Location Of Homonymous Scotomas Influence RS Harwerth, AS Vilupuru, NV Rangaswamy, EL Smith III The Frequency Of Traffic Accidents? – A Study Based On Virtual Reality Driving Tasks U Schiefer, G Hardiess, F Schaeffel, H Wiethoelter, HO Karnath, R Vonthein, 2:45 – 3:00 Early Glaucoma Detection: A Comparison Between Scanning Laser Polarimetry B Schoenfisch, HA Mallot, E Papageorgiou With A Variable Corneal Compensator And Rarebit Perimetry P Brusini, ML Salvetat, M Zeppieri, C Tosoni, L Parisi, M Felletti, V Bais, 4:40 – 4:55 Glaucoma And Fitness To Drive: Predicting A ‘Milestone To Blindness’ I Bignucolo VMF Owen, DP Crabb, AC Viswanathan, ET White, DF Garway-Heath, RA Hitchings 3:00 – 3:15 Mapping Measurements Of The Retinal Nerve Fiber Layer To The Visual Field Using A Non-Linear Bayesian Neural Network 4:55 – 5:00 Retinotopic Organization Of Human Primary Visual Cortex Correlates With The Pattern H Zhu, DP Crabb, PG Schlottmann, DF Garway-Heath, P Healey, P Mitchell Of Visual Field Thresholds RO Duncan, PA Sample, RN Weinreb, LM Zangwill (Poster) 3:15 – 3:30 Relevance Vector Machine For Combining HRT II And SWAP Results For Discriminating Between Healthy And Glaucoma Eyes 5:00 – 5:05 The Frequency-Doubling Effect For Various Spatio-Temporal Conditions C Bowd, C Chiou, J Hao, L Racette, LM Zangwill, FA Medeiros, T-W Lee, RN M Zeppieri, K Kent, S Demirel, CA Johnson (Poster) Weinreb, MH Goldbaum, PA Sample 5:05 – 5:20 Sub-Layer Segmentation Analysis Of The Macular OCT Scan Significantly Detects Damage 3:30 – 3:35 Correlation Of The Structural And Functional Changes In The Early And Preperimetric In Unilateral Optic Neuropathy Stages Of Glaucoma R Kardon, VA Shah, M Haeker, MD Abramoff, M Sonka C Matsumoto, H Nomoto, S Takada, S Okuyama, S Hashimoto, E Arimura, (Poster) 5:20 – 5:25 Relationship Between Fixation Status Evaluated With SLO Microperimetry And Critical 3:35 – 3:50 D etecting Structural Progression In Longitudinal Series Of Optic Disc Images Print Size Before And After Photodynamic Therapy AJ Patterson, DF Garway-Heath, C Bergin, DP Crabb K Fujita, R Mori, Y Mizutani, S Kashiwakura, M Yuzawa (Poster) sessions 3 + 4 3:50 – 4:05 Longitudinal Evaluation Of Experimental Retinal Nerve Fiber Layer Defects 5:25 – 5:40 Relationship Of Binocular Asymmetry In HRT NFL Thickness To The Binocular By SLP, CSLO, And OCT Asymmetry Of HVF 24-2 Among Clinic Referral Patients And FDT Screening Failures B Fortune, G Cull, L Wang, M Zeppieri, GA Cioffi In Bexar County, TX WE Sponsel, M Sinai, Y Trigo, J Hendricks, GC Lindhorst, L Nguyen 4:05 – 4:25 Coffee, Exhibits and Posters 5:40 – 5:45 Publications On Perimetry Listed In The National Library Of Medicine M Zulauf, C Castelberg (Poster)

5:45 – 6:00 Relative Risk Of Progessive Glaucomatous Visual Field Loss In Patients Enrolled And Not Enrolled In A Prospective Clinical Study DB Henson, S Shambhu scientific program program scientific

15 scientific program session 5 THURSDAY, JULY 13, 2006

7:30 – 8:00 Breakfast and Sponsor presentation – Carl Zeiss Meditec

S E S SION 5 : Imaging To Assess Optic Nerve Head Susceptibility - Connective Tissues, Blood Supply And Metabolism Moderators: Claude Burgoyne and Bal Chauhan

8:00 – 8:20 Three Dimensional Optic Nerve Head (ONH) Anatomy – Target Structures And Target Measurements For Clinical Imaging C Burgoyne

8:20 – 8:45 ONH Biomechanics – What’s Important To Measure And Why? C Downs, I Sigal

8:45 – 9:05 Preclinical Changes to Optic Disc Topography in Ocular Hypertensive Patients B Chauhan

9:05 – 9:25 Imaging The Optic Nerve Head In Experimental Rodent Models Of Glaucoma F Cordeiro, F Fitzke

9:25 – 9:45 High-Resolution Imaging Of Retinal And Optic Nerve Head Changes In Optic Neuropathies J Werner, S Choi, RJ Zawadzki, JL Keltner

9:45 – 10:05 Detecting Functional Compromise Prior to Cell Death: Non-Invasive Imaging of Mitochron- drial Function in Retinal Tissue in Ocular Hypertension and Primary Open Angle Glaucoma R Zuckerman

10:05 – 10:25 High-Speed Ultra-High Resolution OCT - Our Experience With The ONH J Fujimoto

10:25 – 10:45 In Vivo Oxygenation Maps Of The Glaucomatous Optic Nerve Head session 5 By Hyperspectral Imaging AMG Baptista, DB Henson, DH Foster

10:45 – 11:00 Open Discussion

11:00 – 11:30 Coffee, Exhibits and Posters

11:30 – 12:00 Sponsor presentation - Pfizer

12:00 – 1:00 Business meeting scientific program program scientific

16 scientific program sessions 6 + 7 FRIDAY, JULY 14, 2006

7:30 – 8:00 Breakfast and sponsor presentation - WelchAllyn

S E S SION 6 : Clinical Perimetry II S E S SION 7: Visual Field Change Analysis Moderators: David Henson and Chota Matsumoto Moderators: Richard Mills and Steve Newman

8:00 – 8:15 Comparison Of Visual Fields And Vision Loss On Everyday Function In Older Diabetics 10:00 – 10:15 Estimating Sensitivity To Change From Signal-To-Noise Analysis Of Test-Retest Data RA Schuchard, AR Bengtzen PH Artes, DM Hutchison, BC Chauhan

8:15 – 8:30 Rarebit Fovea Test In Diabetes 10:15 – 10:30 Change Detection Based On An Individual Patient’s Variability M Nilsson, G von Wendt, L Martin A Turpin, AM McKendrick, BC Chauhan

8:30 – 8:45 Correlation Of M-CHARTSTM And PHTTM Findings With Subjective Perception 10:30 – 10:35 Detectability Of Glaucomatous Changes Using SAP, FDT, SWAP, Flicker Perimetry, Of Metamorphopsia In Patients With Macular Diseases And OCT E Arimura, C Matsumoto, H Nomoto, S Hashimoto, S Takada, S Okuyama, H Nomoto, C Matsumoto, S Takada, S Hashimoto, S Okuyama, Y Shimomura, Y Shimomura E Arimura (Poster)

8:45 – 9:00 Automated Static Perimetry In Eyes With Central Serous Chorioretinopathy 10:35 – 10:50 Linear Regression Analysis Of The Cumulative Defect Curve By Sectors And Other Criteria H Iijima Of Glaucomatous Visual Field Progression M Gonzalez de la Rosa, M Gonzalez-Hernandez, T Diaz Aleman 9:00 – 9:05 Full Threshold Perimetry In Normal Afro-Americans And Caucasians JC Merritt (Poster) 10:50 – 10:55 Monitoring The Visual Field Changes Using Semi-Automated Kinetic Perimetry (SKP) In Patients Taking Vigabatrin 9:05 – 9:20 Low Spatial Frequency Contrast Sensitivity Deficits In Magnocellular And Parvocellular K Nowomiejska, J Paetzold, R Rejdak, T Zarnowski, U Schiefer (Poster) Pathways In Glaucoma AM McKendrick, G Sampson, DR Badcock 10:55 – 11:10 Perimetric Progression Detection In Glaucoma Studied With Event-Detection Algorithms Applied To Linear Deteriorations: Adaptive Inter-Test Intervals Are More Efficient Than 9:20 – 9:35 The Relationship Between Lowering Intraocular Pressure And Prognostic Factors Fixed-Space Inter-Test Intervals For Progression Of Visual Field Damage In Patients With Normal Tension Glaucoma NM Jansonius Y Yamazaki, T Nakagami, F Hayamizu sessions 6 + 7 11:10 – 11:15 Does The Enlargement Of Retinal Nerve Fiber Layer Defects Relate To Disc Hemorrhage 9:35 – 10:00 Coffee, Exhibits and Posters Occurrences Or Visual Field Loss Progression In Normal-Tension Glaucoma? K Nitta, Y Mawatari, Y Saito, S Ohkubo, K Sugiyama (Poster)

11:15 – 11:30 Influence Of Ageing On Visual Field Defects Due To Stable Lesions T Rudolph, L Frisen

11:30 – 12:00 Sponsor presentation - Allergan

12:00 – 1:30 Lunch scientific program program scientific

17 scientific program sessions 8 + 9 FRIDAY, JULY 14, 2006

S E S SION 8 : Comparison of Perimetric Tests S E S SION 5 : Analysis of Visual Field Data Moderators: David Garway-Heath and Aiko Iwase Moderators: Fritz Dannheim and Michael Wall

3:30 – 3:45 Quantifying “Second-Eye” Sensitivity Loss In Frequency-Doubling Perimetry 1:30 – 1:45 Retest Variability Of Conventional Automated Perimetry Of Size V Compared To Size III AJ Anderson, AM McKendrick Stimuli In Glaucoma Patients M Wall, CF Brito, KR Woodward, CK Doyle 3:45 – 4:00 Stabilization And Comparison Of Top And Bracketing Perimetric Strategies Using A Threshold Spatial Filter 1:45 – 2:00 Long-Term Fluctuation, Learning Effect, Sensitivity And Specificity Of Standard M Gonzalez de la Rosa, M Gonzalez-Hernandez, T Diaz Aleman, Automatic Perimetry, Pulsar Perimetry And Frequency-Doubling Technology M Sanchez Mendez M Gonzalez-Hernandez, M Gonzalez de la Rosa, R Rodriguez de la Vega, A Hernandez-Vidal 4:00 – 4:05 Automated Staging Of Visual Field Defects In Glaucoma P Brusini, C Tosoni, M Zeppieri, L Parisi, V Bais, M Felletti, I Bignucolo (Poster) 2:00 – 2:15 A Comparison Of Standard Automated Perimetry, FDT N-30 And FDT 24-2 Tests Of Visual Function In The Diagnostic Innovations In Glaucoma Study 4:05 – 4:20 Assessing Visual Field Clustering Schemes Using Machine Learning Classifiers L Racette, D Ng, FA Medeiros, LM Zangwill, RN Weinreb, PA Sample In Standard Perimetry C Boden, K Chan, PA Sample, J Hao, T-W Lee, RN Weinreb, M Goldbaum 2:15 – 2:20 Comparison Of Frequency Doubling Technology Perimetry, Off-Perimetry, And On-Perimetry In Eyes With Glaucoma 4:20 – 4:35 Spatial Characteristics Of Visual Field Progression Determined By Monte Carlo S Kogure, H Iijima, K Kashiwagi, S Tsukahara (Poster) Simulation: Diagnostic Innovations In Glaucoma Study (DIGS) JP Pascual, U Schiefer, J Paetzold, LM Zangwill, I Tavares, RN Weinreb, 2:20 – 2:35 Evaluation Of The Screening Performance Of The Oculus Easyfield And Frequency PA Sample Doubling Technology (FDT) Perimeters CA Johnson, M Fingeret, A White 4:35 – 4:40 Repeatability Of Automated Perimetry Using Stimulus Size V In Normal Subjects: A Comparison With Size III 2:35 – 2:50 Research On The Application Of Optic Nerve Fiber Map To Fundus Perimetry CK Doyle, M Wall, CF Brito, KR Woodward (Poster) N Suzuki, H Yaguchi

sessions 8 + 9 4:40 – 4:55 Why Are SITA-SWAP Sensitivities Higher Than Those From Full Threshold SWAP? 2:50 – 3:05 Differences Between SWAP And White-On-White Visual Fields: Effects Of Visual SK Gardiner, S Demirel, B Fortune, CA Johnson, A Turpin Adaptation Within A Healthy Population A Eisner, MD Toomey, LJ Incognito, JP O’Malley, JR Samples 4:55 – 5:10 Comparison Of Central Contrast Responses To Luminance Increments And Decrements In Glaucoma 3:05 – 3:30 Coffee, Exhibits and Posters G Sampson, AM McKendrick, DR Badcock

5:10 – 5:20 Closing Remarks scientific program program scientific

18 abstracts

THE MADE IN OREGON SIGN on the north side of the Burnside Bridge is one of Portland’s most enduring icons. The sign was built in 1927 advertising White Satin Sugar (with the lettering “White Satin”). It became the White Stag sign in 1959 with a change in lettering and the addition of a leaping deer and the word “sportswear”. In 1989, the White Stag company moved to California. With another lettering change, the sign was transformed to say “Made in Oregon”. The sign uses neon and incandescent light and is 48’ tall by 46’ wide. The stag’s nose has been lit red (a la Rudolf the Red-Nosed Reindeer) for the Christmas holidays since 1957. The sign is located in an area of downtown called “Old Town”. Hence the “Old Town” neon light at the bottom of the sign.

THE JAPANESE GARDEN Tucked above the International Rose Test Garden, The Japanese Garden has been proclaimed one of the most authentic Japanese gar- dens outside Japan. Five tradi- tional garden styles, a ceremonial teahouse and a pavilion combine to capture the mood of ancient Ja- pan. A haven of tranquil beauty, the Japanese Garden covers 5.5 acres and has a magnificent view of Portland and the surrounding mountains.

19 2 0 0 6.07.12 8a–9:40a abstracts session 1: clinical perimetry I

Visual Performance Test: Results In Hemiopic Evaluation Of Relative Afferent Pupillary Defect In Visual Field Abnormalities 10 Years After Optic Defects And In Follow-Up Of Compensational Patients With Homonymous Visual Field Defects Neuritis: Experience In The Optic Neuritis Treat- Rehabilitation Training Due To Cerebrovascular Lesions In The Posterior ment Trial (ONTT) And Middle Cerebral Artery Territories F Dannheim1, D Verlohr 1,2. Outpatient Eyecare Unit, Seevetal, GER1, Center for Neurological Therapy, Jesteburg, GER2 E Papageorgiou1, 6, G Hardiess2, HA Mallot2, B Wilhelm1, F JL Keltner1, 2, CA Johnson3, KE Cello1, RL Gal4, AD Kalajian4, Schaeffel1, H Wiethoelter3, LF Ticini4, 6, R Vonthein5, HO C Kollman4, RW Beck4, and the Optic Neuritis Study Group. PURPOSE: To demonstrate a test for assessing the real handicap Karnath4, U Schiefer1. Center of Ophthalmology, Tuebingen, FRG1, Dept. of Ophthalmology and Visual Science, Univ. of Calif., Davis, due to visual pathway lesions and for follow-up of rehabilitation 2 1 training. Dept. of Zoology, Lab of Cognitive Neuroscience, Tuebingen, FRG , Sacramento, CA Department of Neurology and Neurological Surgery, Dept. of Neurology, Buerger Hospital, Stuttgart, FRG3, Section Univ. of Calif., Davis, CA2 Discoveries in Sight, Devers Eye Institute, METHODS: This test measures the binocular reaction time for black Neuropsychology, Center of Neurology, Tuebingen, FRG4, Depart- Portland, OR3 Jaeb Center for Health Research, Tampa, FL4 objects on a CRT screen in a symmetrical grid of 11 positions ment of Medical Biometry, Tuebingen, FRG5, EU-PERACT MEST- within the central 34° field, superimposed on a bright landscape. CT-2004-5043216 PURPOSE: To evaluate visual field abnormalities 1, 5 and 10 years Saccades are recommended. Reaction times are saved for 2 con- after the Optic Neuritis Treatment Trial (ONTT). secutive series. An asymmetry index gives the mean of differ- PURPOSE: (i) To assess the presence and magnitude of relative METHODS: Three readers independently classified 1,684 visual session 1: clinical perimetry I ences in reaction time within each pair of corresponding search afferent pupillary defect (RAPD) in patients with homonymous fields 1, 5 and 10 years after acute optic neuritis. Two readers targets in % of the time in the center. This exam was performed visual field defects (HVFDs), (ii) to characterize the location of independently classified 2,148 visual fields 2, 3, and 4 years after in 38 patients with absolute homonymous visual field defects, 29 the cerebral lesions associated with the pupillary findings, and optic neuritis. Readers used a classification system developed of them complaining of restrictions in daily life. In 3, neglect was (iii) to assess the agreement of RAPD quantified with graded for the ONTT which consisted of 21 monocular classifications primarily treated by neuropsychologists. Visual fields were ob- neutral density filters and automated video pupillography. tained with the Oculus Easyfield screening program (Center for and 10 binocular classifications. Reader agreement determina- Neurological Therapy) or with the Octopus 1-2-3 program G1X METHODS: RAPD was initially quantified clinically by two inde- tions are still pending the third reader’s evaluations. pendent examiners with graded neutral density filters (swinging (Outpatient Unit). Compensational visual rehabilitation training RESULTS: Abnormal visual field and binocular classification fre- flashlight test), and secondly by means of an automated infrared of search saccades was individually selected and administered. quencies remained consistent at 41% for years 1, 5, and 10. Ab- videopupillographic device (SWIFT = automated SWInging normal visual field and binocular classification frequencies were RESULTS: The reaction time was in most patients prolonged within Flashlight Test). Agreement was measured by Cohen’s kappa. similar at 46%, 39%, and 41% for years 2, 3, and 4, respectively. the homonymous field defect, at least in parts of it. The response Cerebral regions potentially involved in the afferent pupillary The most common monocular classifications were paracentral before the training within the “unaffected” hemifield, however, pathway were extracted by superimposing the MRI scans on the and partial arcuate defects for all years 1, 5 and 10; the most was in 24 of all 38 cases also abnormally delayed. Nineteen symp- MRIcro software. Twenty-four patients (7 females, 17 males, common binocular classification for all years was binocular un- tomatic patients received compensational visual rehabilitation aged 21–74 years) with HVFDs due to unilateral vascular brain rds rd related. training, improving asymmetry in 2/3 of cases, whereas 1/3 lesions (minimal visual acuity 16/20) participated in this study. showed considerable fluctuations due to other neurological and CONCLUSION: Frequencies for the 1, 5 and 10-year visual field RESULTS: RAPD was present in 11/24 patients (magnitude: me- neuropsychological deficits. The asymmetry index before the classifications were similar, with paracentral and partial arcuate dian 0.3 log units, range 0.3–0.9 log units). Agreement (Cohen’s training was between 867 and 134 (mean 392), reduced by 21-89% defects as the most common monocular classifications and bin- kappa) between examiners was 0.75 (SE 0.13), but only 0.11 (SE (mean 61%) after the training. The prolonged reaction time in the ocular unrelated as the most common binocular classification. ‘unaffected’ hemifield, as present in all but one of these treated 0.22) between the senior examiner (U.S.) and SWIFT after di- patients, was also highly reduced after the training, whereas all chotomization at 0.3 log units. RAPD occurred contralaterally to visual fields were unchanged. the affected hemisphere in all cases. In patients without RAPD, lesions were typically restricted to the primary visual cortex CONCLUSIONS: This simple and quick visual performance test is close to the calcarine sulcus, whereas in patients with RAPD, a valuable quantitative diagnostic tool in addition to the more the lesion overlap affected the course of the optic radiation in abstracts tiresome conventional static perimetry and to neuropsychologi- the temporal white matter. cal tests for divided and selective attention as well as for neglect syndrome. It allows quality assessment of compensational visual CONCLUSIONS: Clear anatomical differences were revealed be- rehabilitation training. tween patients with and without RAPD. Automatically and clini- cally assessed RAPD showed only fair agreement, probably due to the low magnitude of RAPD. go to a different site the following month on days 1 or 4. seenophthalmologistbythebe to to orsitesameatthe4day on tested positively on days 2 or 3 were given the option of returning whoScreenees eyes. both in 4) & 1 (daysscreening each of day exam were performed by an ophthalmologist on the first and final ophthalmoscopic and exam slit-lampA an technician. experienced by eyes both in tonometry non-contact Reichert and laser, HeidelbergTomographyRetinal SITA scanning 30-2, II) (HRT (HVF) Field Visual Humphreyunderwent FDT the on miss 1 erly identified will inevitably need to be addressed. by a trained technician who performed history, digital blood pres Each screening was carried out in two stages: the initial screening Unit. Screening EyeMobile Lions 60-foot heated and ditioned air-con an using 40) and 34, 27,32, 23, 21,29,30, 22, 15,20, 12, oftheregion’s retailer, leading(HEB grocery stores9,5, # 10, 11, lot parking the in differentsitesatmonthlyheld were glaucoma glaucoma screenings atin Bexar County, Texas. disorders eye sight-threatening other or glaucoma for tively TX Antonio, San Center, Science Health Texas of University Ophthalmology, Sponsel. WE HKoenig, Y Trigo, JHendricks, 165 chose not to stay for further evaluation. examination by the ophthalmologist, but did not return. A further 49madeappointments forontestingandDay4return further to screening, initial the on FDT the failed who 454 the Of 4. day screenings.4-day The remainder (151 from days 1-3) returned on the of 4 or 1 days on examined immediatelywere 89 240, these Among ophthalmologist. an by disorders eye sight-threatening failed,were 240 havingas glaucoma clinicallyconfirmed or other ar County glaucoma screenings, 454 failed the FDT. Of those that with positively screening Those C-20-5. (FDT)Technology sure, visual acuity using the Optec 2500, and Frequency Doubling to be factors, but economic and sociologic issues yet to be prop be to yetissuessociologic and economicbut factors, be to distance between the screening and clinical follow-up site appear very high levels of diagnostic sensitivity and specificity. Time and screeningaddressed,methodswith beparticularly now attaining must that problem critical a is disease ocular sight-threatening RESULTS: METHODS: PURPOSE: In Bexar County, TX Screening Positively For Sight-Threatening Disease Clinical Follow-Up Return Rates Among Those abstracts CONCLUSION: Among 4630 individuals screened during 2 years of Bex To determine the return rate of those screening posi screening those of rate return the Todetermine ordyln (udy Wdedy sreig for screenings Wednesday) - (Sunday Four-day-long Follow-up compliance among those at high risk for risk high at those Follow-upamong compliance

session 1: clinical perimetry I perimetry clinical 1: session ≥ - - - - -

optic neuropathy secondary to demyelinating disease, compres disease, demyelinating to secondary neuropathy optic to due changes arcuate residual minimal detect to patient, Chloroquine 1 in to secondary maculopathy early define better to defining residual damage. residual defining in useful be may I size a pathology of suggestive etc.) atrophy, optic defect, pupillary (afferent evidence other is there yet and subtle to due or macula When optic the nerve normal dysfunction. field looks either problems residual suggests examination and history clinical the when abnormalities subtle detecting in Virginia Charlottesville, Ophthalmology, of Department Newman. SA confirm otherwise unseen or poorly defined defects. defined poorly or unseen otherwise confirm with either utilized a 10-2 or program a to program 24-2 detect or year atperiod the University of the size Virginia I test object was fects due to residual damage secondary to pituitary tumors in in 2 patients. tumors pituitary to secondary damage residual to due fects de bitemporal subtle and patients, 8 in neuropathy optic sive unseen. otherwise pathology detect The use of I be a may entirely normal. object be test ablesize to may perimetry standard the dysfunction residual or with patients cases early some in function, retinal and nerve optic in ties size III test object usually detects relatively subtle abnormali subtle relatively detects usually object test III size CONCLUSIONS: CONCLUSIONS: RESULTS: METHODS & MATERIALS PURPOSE: Neuropathies And Macular Pathology Use Of The Size I Test Object For Subtle Optic In the series of patients the 10-2 with a size I was able was I size a with 10-2 the patients of series the In Although standard perimetry (white on white) with a with white) on (white perimetry standard Although The use of the size I test object may be helpful be may object test I size the of use The : In a series of 16 patients seen over a 20 20 a over seen patients 16 of series a In : - - - dose, a higher rate of field progression cases was seen at an in an at seen was cases progression field of by rate higher a stratified dose, when However, definitions. 4.8%) vs (5.3% case validated and 11.7%) vs (12.4% case all the using controls and patients treated pregabalin between equivalent was progression field visual apparent of cases of percent RCTsthe In patients. discussed. be will defect field visual related drug a of absence the dem onstrate to studies design to way optimal more a and experience this from learned Lessons label. product the in safety mologic ophthal regarding precaution patient a included and pregabalin of safety visual the of convinced not FDA the was this, Despite somnolence. some causes that drug active CNS a with pected remained. deterioration field of rate the studies, OL in exposure long-term With doses. but notplacebo, to at lower compared or dose higher termediate patients for treated epilepsy, disorder in random pain or anxiety 3621 in followed were Fields fields. visual screening point 120 Humphrey followedwith were Patients presented. be will gram paper. this in discussed be will of results interpretation and definitions case design, study around Issues common. increasingly become have status field visual gitudinal MI USA Arbor, Ann Inc, Pfizer MG Brigell. studies, assessed whether the change was clinically expected expected history. on ophthalmologic based clinically was change the whether assessed studies, open-label for and, change significant clinically a validated who ofpool it. was then This cases reviewed by experts field 3 visual an of increase 10 or more from points on missed baseline any vis or deterioration, field of impression ophthalmologist examining events; adverse patient either by defined were progression tial long uncontrolled open-label term (OL)of Cases studies. poten in and duration in weeks 12 to up (RCTs)of trials clinical ized iul des efcs f rg, aey tde mntrn lon monitoring studies safety drugs, of effects adverse visual CONCLUSION: RESULTS: METHODS: PURPOSE: The Pregabalin Experience The Role Of Perimetry In Assessing TheOphthalmologic Safety Of Drugs: Baseline field abnormalities were present in 15.1% of 15.1% in present were abnormalities field Baseline With increased sensitivity of regulators to potential potential to regulators of sensitivity increased With A review of the pregabalin phase 3 visual safety pro safety visual 3 phase pregabalin the of review A iul il rsls ee s od s ol b ex be could as good as were results field Visual 6.07.12 0 0 2

8a–9:40a 0 4 : 9 – a 8 21 ------

abstracts session 1: clinical perimetry I 2 0 0 6.07.12 8a–9:40a abstracts session 1: clinical perimetry I

Central Mean Sensitivity And Non-Penetrating Patho-Physiology Of Nasal Myopic Super-Traction Trabeculectomy & Possible Related Complications R Inoue, A Kozaki, T Inoue, Y Inoue, Olympia Eye Hospital, JM Enoch1, 2, JB Crawford2, EL Howes2, SS Choi3, D Ling4, J Tokyo, Japan Lee4, K Laverty5. School of Optometry, University of California, Berkeley (UCB), Berkeley, USA1, Department of Ophthalmology, UC PURPOSE: The aim of this study is to evaluate the central mean San Francisco, San Francisco, USA2, Department of Ophthalmol- sensitivity (MS) in open angle glaucoma patients with the central ogy, UC Davis, Sacramento, USA3, School of Public Health, UCB, impairment of visual field, in order to prevent the loss of central 4 visual acuity after surgical procedure. Berkeley, USA , Department of Molecular and Cell Biology, UCB, Berkeley, USA5 METHODS: Material was comprised of 85 eyes in 70 patients (POAG, 56 eyes in 46 patients, NTG 29 eyes in 24 patients). An average PURPOSE: Since the late 19th Century, aspects of patho-physiol- age was 50.2±11.7 (26-78) years. In all patients MSs were exam- ogy of “nasal myopic super-traction of the retina and choroid onto ined by Octopus (201), program M2, and Delta analysis was per- the optic nerve head” have been known. These have been poorly formed for the calculation of MS in each quadrant. In this study elucidated. We consider here a number of issues pertaining to this non-penetrating trabeculectomy (NPT) was employed. The and other common disc-related complications of high myopia. session 1: clinical perimetry I mean follow-up period was 60 months (range 24-115). METHODS: In cooperation with the Armed Forces Institute of Pa- RESULTS: In 21 eyes (24.7%), MS within 5 degrees decreased over thology, Washington, DC, histological findings in “nasal myopic 2dB. Subgroup analysis was performed on two groups: 1) MS super-traction” were presented. We considered early German in- within 5 degrees decreased over 2dB (21 eyes), 2) MS did not vestigations of this disorder, e.g., Elschnig, 1901, and recent im- change before and after surgery (64 eyes). In group 1, MS within portant data of Shimada, et al., 2006. We sought to understand 5 degrees, MSs of upper temporal and lower nasal before surgery both “myopic conus” and encroachment of retina and choroid was lower than group 2 (p<0.05). The patients, who had visual onto the optic disc. We introduced OCT II records of this dis- field defect in 2 or more quadrants before surgery, decreased MS order, and perimetric data utilizing fundus-camera-perimetry. after surgery (P<0.01). We attempted to relate patho-anatomical findings to separately- determined visual functions upon and adjacent to the disc in af- CONCLUSION: Central MS was decreased after NPT in the ad- fected individuals. vanced glaucoma patients who have visual field defect in 2 or more quadrants within 5 degrees. A detail visual field measure- RESULTS: Separate or partially related mechanisms may cause ment within 5 degrees was useful for the judgment of NPT in the nasal myopic super-traction, myopic conus, and peripapillary advanced glaucoma patients. detachment in pathological myopia (PDPM). We differentiated between different degrees of hyperemia on the disc in individuals with nasal myopic super-traction, and considered neural pathways of nerve fiber bundles at the disc. We related our data to subject OCT II records. We discuss the fate of the residuum of the RPE in morning glory anomaly, and separately in OCT II studies, and address research of Shimada on PDPM and note its relationship to nasal myopic super-traction. CONCLUSIONS: Three disc-related anomalies associated with high and pathological myopia have been considered; nasal myopic abstracts super-traction has been emphasized. Available histology, simi- larities and differences were addressed. OCT records have been presented and compared. Distinct patterning was found. In the presence of nasal myopic super-traction, on-disc visual functions 2 2 exhibited reduced sensitivity, and transient alterations in stimu- lus detection and photoreceptor alignments. all at least one presentation per location faster than the test al test the than are faster location per REMU) presentation one least and at all Z-CONT (Z-GAUSS, algorithms retest the ly More Accurate Than Current Procedures 2005. p43-51. 2005. loss. field of visual areas in variability measurement to reduce old procedures and threshold approaches. retest two other the than curate ac more and faster is REMU re-test, to test from change fields When accurate. more dB 0.5 least at and average, on gorithms, tests. vious pre from derived information threshold of use makes that dure A Turpin [1] McKendrick & Turpin. Combining perimetric suprathresh perimetric Combining Turpin. & McKendrick [1] Z-GAUSS and Z-CONT next. the to one visit from than change when fields accurate more is REMU and SITA, as such algorithms test gold-standard current than curate belowdB. 1.5 falls deviation standard when the terminated is ZEST the and dB, 3 of deviation standard initial an has pdf ian pdf centred 2 dB below the failed supra-threshold value. The same as a previous, otherwise ZEST is using performed a Gauss is reported threshold the then seen, are supra- presentations threshold three of two or two If correction. general-height a location with that at threshold previous the on based location each a is test supra-threshold made for and Specifically, accuracy. test time test off trade to procedures threshold ZEST and threshold our on previously published EMU[1] algorithm which supra- combines based is (REMU) algorithm new Our (Z-GAUSS). old running pdf aboutthresh a the with ZEST measured previous Gaussian and (Z-CONT); pdf input the re-initialising without test previous the from continue and to ZEST (FT) allowing (Z); Threshold ZEST Full information, previous of not use do make that algorithms threshold existing two running simply included systems Baseline algorithms. retest several analyse to used was unreliable) and false-negative, false-positive, (none, Australia Melbourne, of University etry, RESULTS: METHODS: PURPOSE: A Perimetric Re-Test Algorithm That Is Significant abstracts CONCLUSIONS: Australia Melbourne, University, RMIT Science, When there is no change in field from test to retest, retest, to test from field in change no is there When To develop a fast and accurate perimetric test proce test perimetric accurate and fast a Todevelop Computer simulation using 4 levels of patient error error patient of levels 4 using simulation Computer 1 , AM McKendrick , AM The new retest algorithms are as fast and more fast as ac are The newalgorithms retest

session 2: new perimetric techniques perimetric 2: new session . January . January Science Vision and Optometry 2 , DJankovic 2 2 Dept of Computer Computer of . Dept 1 , Dept of Optom of , Dept ------external angle were smaller on the peripheral isopters. In glau In isopters. peripheral the on smaller were angle external the of variation inter-individual and Intra perimetry. kinetic in variation inter–individual than smaller was variation individual Intra- speeds. target or sizes target age, subject by affected not were angles external The patients. glaucoma in degree 240 to da cine, Osaka, Japan Osaka, cine, Medi of School University Kinki Hospital Sakai Ophthalmology, rimetry. pe Goldmann the with compared correspondence acceptable 5 eyes and had 13 correspondence eyes had good patients, coma perimetry kinetic Goldman eyes of 18 patients were glaucoma with the and compared tested 18Using variation. algorithm, this for evaluating intra-individual conditions test same the with times 5 tested were subjects mal nor 8 of eyes Eight sec. / degree 6 4, 2, I/2e, speeds target I/3e, and I/1e I/4e, V/4e, sizes target of conditions test the under ing the inter-individual of variation automated perimetry kinetic movedwas pe from (stage1), First target the test points. sponse Octopus101. the using patterns isopter abnormal evaluating and detecting for K) gram Thirty four eyes of 34 normal subjects were tested for evaluat for tested were subjects normal 34 of eyes algorithm. four this Thirty for parameters test suitable the evaluated and perimeter Goldman by obtained fields visual glaucomatous 100 on algorithm this simulated we study, this In patterns. isopter abnormal the detecting for repeated were (stage sequences These area 2). isopter abnormal the to automatically added were tests and additional were analyzed points of the angles response point to riphery on the The fixation meridian. the external fixed CONCLUSION: RESULTS: METHODS: AND SUBJECTS PURPOSE: Kinki University School of Medicine, Osaka, Japan Osaka, Medicine, of School University Kinki evaluating the automated kinetic visual fields. visual kinetic automated the evaluating S Hashimoto abnormality of isopter patterns by the external angles of the re the of angles external the by patterns isopter of abnormality A New Approach To Automated Kinetic Perimetry 1 , SOkuyama The normal range of the external angle was from 150 from was angle external the of range normal The To develop a new automated kinetic algorithm (Pro algorithm kinetic automated new a Todevelop Program K is a useful method for detecting and and detecting for method useful a is K Program 1 , CMatsumoto 1 , YShimomura 2 Our new kinetic algorithm judged the the judged algorithm kinetic new Our 1 , HNomoto 1 Department of Ophthalmology, Ophthalmology, of . Department 1 , EArimura 1 .Department of of .Department 2 , STaka ------tory, Matsushita Electric Works, Ltd, Kadoma, Japan Kadoma, Ltd, Works, Electric Matsushita tory, point. Eight glaucoma patients with various visual field distur field visual various with patients glaucoma Eight point. each at averaged were responses pupillary Three degrees). 25 and 10, 5, 15,20, 0, direction (each 315werestimulated degrees Fukushima glaucomatous visual field defects. field visual glaucomatous F Maeda perimetry. pupil by decreased have to found was contraction pupillary 2), 30- (Humphrey perimetry static conventional with shown was area Bjerrum the in defect fiber nerve retinal the to compatible de was defect field contraction novisual although one case, in addition, In creased. pupillary existed, defect field visual where position the the at cases, other In defects. field visual tous were examined. bances of cd/m 300 tensity Medical Science, Kanazawa, Japan Kanazawa, Science, Medical of School Graduate University Kanazawa Ophthalmology, of ment traction ratio is analyzed. The stimulus parameters were an in an were parameters stimulus The analyzed. is ratio traction crystal display and an infrared CCD camera. The diameter of the pupil diameter is in measured a The darkened room, and the con pupillary camera. CCD infrared an and display crystal Kurashiki, Japan Kurashiki, Welfare, Medical of University Kawasaki Science, Sensory of ment glaucoma patients. glaucoma CONCLUSIONS: RESULTS: METHODS: PURPOSE: cd/m 0.50 of intensity background a and Hz 10 in flickering with ms Pupil Perimetry In Glaucoma 2 . Twenty-one points on the meridians of 45, 135, 225, and and 135,225, 45, of meridians the Twenty-oneon . points One case was not able to evaluate correctly glaucoma correctly evaluate to able not was case One 1 To evaluate our newly developed pupil perimeter in in perimeter pupil developed newly our evaluate To Our new pupil perimeter consists of a 19-inch liquid 19-inch a of consists perimeter pupil new Our , KTanzawa 2 , SInakagata Pupil perimetry may be able to objectively detect detect objectively to able be may perimetry Pupil 1 , Advanced Technologies Development Labora Development Technologies , Advanced 2 , a diameter , of a a diameter 4.0 ofduration degrees, 400 1 , TYoneda 2 , SOhkubo 3 1 6.07.12 0 0 2 , K Kani1, ATabuchi, KKani1, 3 , KSugiyama 1 1:25a –11: a 10 2 , Depart 3 . Depart 1 , S - - - 3 2 - - - - -

abstracts session 2: new perimetric techniques 2 0 0 6.07.12 10a–11:25a abstracts session 2: new perimetric techniques

Multifocal Dichoptic Pupillography In Glaucoma The Effect Of Stimulus Orientation, Learning Pulsar Perimetry In The Detection Of Early And Central Refraction On A New Multi-Location Glaucomatous Visual Field Loss AC James, T Maddess, XL Goh. ARC Centre of Excellence in Vi- Motion Displacement Test For The Detection Of 1 1, 2, 3 1 1 1 sion Science and CVS-RSBS, ANU, Canberra, Australia Glaucoma ML Salvetat , M Zeppieri , C Tosoni , L Parisi , V Bais , M Felletti1, I Bignucolo1, and P Brusini1. Department of Ophthalmol- PURPOSE: This study was a preliminary investigation of a means 1 GM Verdon-Roe1, 2, MC Westcott3, R Moosavi,1 , D Gore,1 AC ogy, S. Maria della Misericordia Hospital, Udine, Italy , Department of concurrently assessing the visual fields of both eyes by re- 1, 2 2 1, 2 of Ophthalmology, University of Udine, Italy2, Discoveries in Sight, cording the responses of both pupils to dichoptic 24 region mul- Viswanathan , FW Fitzke , DF Garway-Heath. Moorfields 1 Devers Eye Institute, Portland, OR, USA3 tifocal stimuli, to investigate the sensitivity and specificity of Eye Hospital, London, UK , Institute of Ophthalmology, London, this as a method for objective perimetry. UK2, St Bartholomew’s Hospital, London UK3 PURPOSE: to assess the ability of Pulsar perimetry in detecting METHOD: Dichoptic stimulation was provided by means of a pair PURPOSE: To investigate the effect of stimulus orientation, learn- early glaucomatous visual field (VF) damage. of stereoscopically arranged LCD displays. Each display pre- ing and central refraction on a new multi-location motion dis- METHODS: One eye of 49 controls, 52 patients with ocular hyper- sented a circular dart-board-like array of 24 stimulus regions placement test (Moorfields MDT™) for the detection of glau- tension (OHT), 97 patients with primary open-angle glaucoma extending to 30˚ eccentricity. Each region in each eye received coma. (POAG) was considered. The POAG group was divided into 47 stimulus presentations at a mean rate of 1/s. The test recording patients with early VF defects (perimetric-POAG) and into 50 duration was 4 minutes, divided into 8 segments. Four stimulus METHOD: A 32-location MDT was presented on a 20-inch flat patients with glaucomatous optic neuropathy and normal VFs presentation conditions were tested: either a single or a 2x2 ar- screen monitor, under PC control, at a test distance of 30 cm. (pre-perimetric-POAG). VFs were assessed using standard auto- ray of patches, being either steady for 133ms or flickered half-on The MDT threshold was determined as the last seen response mated perimetry (SAP) SITA standard HFA 30-2 test and Pul- half-off at 15 Hz for 266ms. The 20 normal subjects were given on the second reversal of a staircase (3-30 min arc displace- session 2: new perimetric techniques sar perimetry (Haag-Streit International) T30W test. The Pulsar a thorough eye exam including 24-2 HFA fields and fundus pho- ment). 16 glaucoma patients (33-76 years), with reproducible fo- stimulus consists of a circular sinusoidal pattern, 5° in diameter tography assessed by a single skilled observer. The 26 patients cal Humphrey defect (MD -1.58 to -7.69), and 17 perimetrically and 500 msec in duration, shown with a pulse motion at 30 Hz. had stable HFA fields. experienced, aged-matched controls (27-75 years) were tested. Near refractive correction [median (range)] was 1.9 (+6.0 to -3.0) Spatial resolution and contrast of the stimulus are simultaneous- RESULTS: Both pupils were recorded with 24 regions mapped in DSph for patients and 1.8 (+6.0 to -4.0) DSph for controls. A ly modified during the test using TOP strategy. The stimulus is each eye, giving a total of 96 measures from each 4-minute re- baseline MDT was done with all line stimuli vertically aligned, presented in 66 test locations within the central 30 degrees. Pul- cord, each with a rigorous estimate of standard error. The me- with near correction, followed by four randomised tests: (i) re- sar test mean deviation (MD), loss variance, number of signifi- dian peak response expressed as z-scores for the 4 conditions peat baseline (ii) repeat baseline, unaided (iii) stimuli orientated cantly abnormal points on the Deviation Probability plot, and were 4.1, 3.3, 3.2 and 2.3. The best diagnostic performance was with the retinal nerve fibre layer (RNFL), with correction (iv) testing time were evaluated. Sensitivity and specificity of Pulsar obtained by taking the mean of the 10 worst deviations from the stimuli orientated perpendicular to the RNFL, with correction. perimetry in detecting glaucomatous damage were calculated normal profile across the visual field regions, providing a joint Statistical evaluation was by nonparametric tests. using different algorithms. sensitivity and specificity of 85% for the flickered single patch RESULTS: Sensitivities at specificity 90% ranged from 53.2% to condition. The analysis method meant that about 10% of each RESULTS: Patient MDT thresholds were significantly elevated ≥ 93.6% in the perimetric-POAG-group and from 36% to 54% in record could be lost due to blinks etc. without affecting accu- compared to controls for all stimulus orientations (p <0.001). the pre-perimetric-POAG group. The percentages of abnormal racy. For patients and controls: there was no significant difference in thresholds between the baseline and repeat baseline; thresh- OHT eyes ranged from 11.5% to 40.4%. The best discriminat- CONCLUSIONS: The method provided diagnostic accuracy that olds were elevated for peripheral locations (> 9˚ eccentricity) ing parameter was the Pulsar MD, with sensitivity at specific- was comparable to leading perimeters even though the raw test with central correction, compared to unaided (p <0.001), with ity ≥90% of 93.6% and 52% in the perimetric-POAG and pre- time was 2 min per eye. Measuring the visual fields of the two no significant difference within 3˚ of central fixation; thresholds perimetric-POAG groups, respectively, with 36.5% of abnormal eyes simultaneously has advantages for comparing the two eyes. of stimuli orientated with the RNFL were elevated when com- OHT eyes. Pulsar test was significantly shorter than SAP test Larger scale trials will be needed to confirm these results. pared to vertical and perpendicular (p <0.001). (P<0.001). CONCLUSIONS: The Pulsar T30W test appeared to be a rapid and abstracts CONCLUSION: All variations of stimulus orientation showed good separation of control with glaucoma. MDT thresholds are robust easy perimetric test, showing high sensitivity and specificity in to central refractive error and learning for perimetrically familiar detecting early glaucomatous functional defects, and providing subjects. The Moorfields MDT™ therefore offers potential as a a higher ability than SAP in detecting VF damage in patients 24 screening device for the detection of glaucoma. at risk of developing glaucoma. The Pulsar test required 60% time than SAP. Supported by an unrestricted grant by Pfizer. abstracts decreased by approximately 1.3Hz per age decade. The regres The decade. age per 1.3Hz approximately by decreased points test 39 over CFF the of values 10°. Mean approximately the central 30° visual field. visual 30° central the in database normative age-dependent we useful a developed perimeters, have series 300 Octopus the with perimetry flicker 4Hz (central) to 8Hz (peripheral). 8Hz to (central) 4Hz from approximately deviation standard a with eccentricity with CFF increased of the values variability Interindividual nificant. insig be to appeared age against values CFF measured single change The with eccentricity. regression ofof short the term fluctuation significantly not did age versus CFF the of slope sion variances. residual smallest the with smoothed and extrapolated interpolated, were point test each at regression ear with the 301.procedure Octopus The werestaircase subjects re using 4-2Hz field at sured 30° visual 39 in the central points test 301 perimeter. Octopus the with perimetry flicker of results a test the for developdatabase normative to tried we population, normal a from obtained ues age-corrected CFF values which were estimated by simple lin simple by estimated were which values CFF The study. age-corrected this in included were subjects normal 130 of eyes thirty and hundred One Japan. in College Medical Sapporo and University, Keio University, at TohokuKinki cruited University val perimeters the characterizing series and assessing 300 through AG), (Haag-Streit Octopus the to program optional an as available commercially being now is perimetry flicker 1991.As since package software remote its and perimeter 1-2-3 Octopus ra CONCLUSIONS: RESULTS: METHODS: PURPOSE: S Okuyama Perimetry With The Octopus 300 Perimeter Characteristics Of The Normal Values For Flicker School of Medicine, Osaka, Japan Osaka, Medicine, of School Sakai Hospital Kinki University School of Medicine, Osaka, Japan Osaka, Medicine, of School University Kinki Hospital Sakai 2 , Y Shimomura The hill of CFF had a gentle ridge of at the eccentricity We have been studying flicker perimetry with the the with perimetry flicker studying been have We rtcl lce fso feunis CF wr mea were (CFF) frequencies fusion flicker Critical 1 , C Matsumoto o eiby siae h ciia ts rsls of results test clinical the estimate reliably To 1 .

Department of Ophthalmology, Kinki University University Kinki of Ophthalmology, Department session 2: new perimetric techniques perimetric 2: new session 1 , S Takada 1 , Department of Ophthalmology, Ophthalmology, of Department , 1 , S Hashimoto 1 , E Arimu 2 ------6.07.12 0 0 2 1 1:25a –11: a 10 25

abstracts session 2: new perimetric techniques 2 0 0 6.07.12 2:30p–4:05p abstracts session 3: optic nerve head and nerve fiber imaging

Age-Related Losses Of Retinal Ganglion Cells And Early Glaucoma Detection: A Comparison Between Mapping Measurements Of The Retinal Nerve Fiber Nerve Fiber Layer Thickness Scanning Laser Polarimetry With A Variable Layer To The Visual Field Using A Non-Linear Bayesian Corneal Compensator And Rarebit Perimetry Neural Network RS Harwerth, AS Vilupuru, NV Rangaswamy, EL Smith III. College of Optometry, University of Houston, Houston, TX, USA P Brusini1, ML Salvetat1, M Zeppieri1, 2, 3, C Tosoni1, L Parisi1, H Zhu1, DP Crabb1, PG Schlottmann2, DF Garway-Heath2, P Healey3, M Felletti1, V Bais1, I Bignucolo1. Department of Ophthalmology, P Mitchell3. City University, London, UK1, Moorfields Eye Hospital, PURPOSE: To study age-related reductions in retinal nerve fiber S. Maria della Misericordia Hospital, Udine, Italy1, Department of London, UK2, University of Sydney, Sydney, Australia3 layer thickness (RNFLT) with respect to two issues. 1) Aging Ophthalmology, University of Udine, Italy2, Discoveries in Sight, De- effects on RNFLT are assumed to be the result of age-related vers Eye Institute, Portland, OR, USA3 BACKGROUND: Clinical measurements of structure and function in glau- losses in retinal ganglion cells (RGCs), but the rates are much coma are noisy but are central to patient management. Much could be different; age-related losses of RGCs are about 0.7%/year com- PURPOSE: To compare the ability of scanning laser polarimetry gained clinically by ‘blending’ the information from these measurements pared to 0.2%/year for RNFLT. 2) The loss of RNFLT is sys- (SLP) with a variable corneal polarization compensator (GDx- especially in identifying disease progression. tematic throughout adulthood in humans, but for an experimen- VCC) and Rarebit Perimetry (RBP) in the discrimination be- tal model it must be determined whether age-related reductions PURPOSE: To develop a methodology for examining the precise spatial re- tween healthy and early glaucomatous eyes. of RNFLT in monkeys are similar to humans. lationship between measurements of the retinal nerve fibre layer thick- METHODS: Fifty patients with early glaucomatous visual field de- ness (RNFLT) from GDx (VCC) scanning laser polarimetry (SLP) and METHODS: In the first study, normative data for RNFLT and vi- fects (mean MD -2.5±1.3 dB; mean PSD 3.2±1.2 dB), and 38 visual field (VF) sensitivities from standard automated perimetry. sual field sensitivities were obtained from the printouts of stan- controls underwent RBP testing and GDx-VCC imaging. One dard optical coherence tomography (OCT) and standard auto- METHODS: Two cross-sectional datasets were used where both SLP scans eye per patient was considered. Differences between the groups mated perimetry (SAP) for patients from ages of 25 to 95 years, and 24-2 VF tests were available: 1800 eyes (normal and glaucoma sus- were evaluated using the Mann-Whitney test. Sensitivity, speci- in decade steps. These data were used in models to estimate the pects) from the population-based Blue Mountains Eye Study were used ficity and area under the receiver operating characteristic curve number of RGCs underlying each measure. In a second study, along with 105 eyes (54 normal subjects and 51 glaucoma patients) re- (AROC) for discriminating healthy from glaucomatous eyes OCT data were collected from 40 macaque monkeys over an age ported by Schlottmann et al (2004 IOVS 45:1823-9). First, (logarithmic) were evaluated for specific GDx-VCC and RBP parameters. range of 3 weeks to 10 years (a human-equivalent range of 0.06 linear ‘correlation/regression’ analysis similar to that of Gardiner et al Cut-off points, defined as the value dividing healthy from glau- to 40 years of age). (2005 IOVS 46:3712-7) was used to predict sensitivities at individual VF comatous eyes with the highest probability, were determined. locations using 64 RNFLT retardation values. Next, VF and RNFLT RESULTS: The age-related losses of RGCs derived from normative SAP test results were taken as the gold standard. The agree- were incorporated into a multi-layered Bayesian neural network (BNN) perimetry data agreed closely with published histologic data, ment between GDx-VCC and RBP results was assessed using for the same prediction task. BNN makes no linearity assumption, it- without an age-variable in the model. In contrast, the age-related the Cohen Kappa. eratively minimises the error in the predicted VF pattern and consid- session 3: optic nerve head and nerve fiber imaginglosses of RGCs derived from normative RNFLT data required RESULTS: Statistically significant differences were found between ers VF and SLP measurements to interact as ‘groups’ rather than single an age-variable of 0.01 µ/year increase in spacing between axons the groups for all GDx-VCC and RBP parameters. The AROC independent measurements. The BNN analysis provides a map of VF in the nerve fiber layer to account for the relatively slower rate of ranged respectively from 0.76 to 0.90 for the GDx-VCC param- points related to RNFLT using expected Jacobian derivative w.r.t RN- RNFL thinning than RGC loss. The RNFLT measurements on eters, and from 0.89 to 0.93 for the RBP parameters. The pa- FLT distribution. monkeys had considerable variability, but regression analysis of rameter giving the largest AROC with GDx-VCC was the Nerve the data on a human age-equivalent scale showed that average RESULTS: The BNN VF sensitivity predictions were on average at least Fiber Indicator (AROC 0.90; sensitivity 86%, specificity 89.5%; RNFLT thinning occurred at the same rate (0.22 µ/year) as for twice as accurate as those predictions based on (logarithmic) linear re- cut-off set at 25); with RBP, the parameter was Mean-Hit-Rate human patients (r = -0.42). gression. The improved prediction (4.3dB average BNN prediction error (AROC 0.93; sensitivity 90%, specificity 97.4%; cut-off set at against 13.2dB in Glaucomatous subjects) verifies the non-linear change CONCLUSIONS: The relationship between RNFLT and RGC axo- 82%). The Cohen Kappa was 0.68. on glaucomatous VF caused by RNFLT thickness damage. Prediction ns varies with the number of neurons lost through normal aging, CONCLUSIONS: Early detection of glaucoma should take into confidence intervals widen in the VF periphery and with the reduction possibly because of a compensating increase in glial tissue in the consideration initial signs of both structural and functional de- of VF sensitivity. nerve fiber layer. The histologic data that are needed for further

abstracts fects. Both GDx-VCC and RBP tests showed a good ability in studies of this relationship can be obtained from macaque mon- CONCLUSIONS: The methodology in this work provides significantly more discriminating between healthy and early glaucomatous eyes, keys because the OCT data demonstrate a similar normal aging accurate predictions of VF sensitivity using RNFLT measurements suggesting that both can be of aid in the early diagnosis of glau- effect on RNFLT as has been found for humans. compared with predictions of linear regression. The topographical maps coma. The agreement between the two test results appeared to of how RNFLT are related to groups of locations in VF derived from this Supported by NEI grants R01 EY01139, R01 EY03611 and P30 be moderate. methodology could be useful in describing precise function-structure EY07751, and an AHAF - National Glaucoma Foundation grant. relationship. did improve AUROCs compared to SWAP alone (p<.001). SWAPalone to improvedid AUROCs compared but (p>0.10), alone HRT on trained RVM to compared AUROCs Combining improve not did p<0.01). OPT) and FD (all (AUROC=0.90, SWAP and HRT PSD=0.72) (MD=0.68, indices global HRT(0.76 classifiers RB 0.81 classifier, FSM and classifier) SWAP for those than larger significantly were also They FD,0.75 OPT). (0.72 SWAP on trained those than larger significantly were OPT) of California, San Diego San California, of glaucoma. Combining these particular measures does not neces not does measures particular these Combining glaucoma. than RVMs accuracy on trained SWAP data for eyes detecting with sarily improve diagnostic accuracy. improve diagnostic sarily available HRTto werecurrently Results compared lin pared. also com were combination in and alone SWAP and HRT on trained RVM AUROC from results sets. (using input data elimination) backward (OPT) optimized and (FD) dimension full for generated were set test the in eyes of classification the for (AUROC) curve characteristic operating receiver the under areas and set, data eye RVMs and test on of212- unique subsets the full to train used was Ten-fold cross-validation combination. in and independently age, plus grid 24-2 the from values 52 and threshold SWAP parameters topography disc optic HRT-determined 80 on tested and trained were RVMs months. three within CA) Dublin, II, Analyzer Field heim, Germany) and tested using full-threshold SWAP (Humphrey discs optic appearing glaucomatous with patients coma combined. and independently measurements, sensitivity visual SWAP and raphy deiros RM lann casfes rie o HT I pi ds topog disc optic II HRT on trained classifiers learning machine (RVM) vector relevance using eyes glaucomatous and healthy ear discriminant function classifiers and SWAP global indices. SWAPglobal and classifiers function discriminant ear Bowd C Healthy And Glaucoma Eyes II And SWAP Results For Discriminating Between Relevance Vector Machine For Combining HRT CONCLUSIONS: RESULTS: Dossen Engineering, (Heidelberg II HRT using imaged were results (SAP) perimetry automated standard abnormal repeatable METHODS: PURPOSE: San Diego of California, University of Ophthalmology, Department Center, Glaucoma Hamilton abstracts 1 , T-WLee , 1 AUROCS for RVMs trained on HRT (0.88 FD, 0.89 0.89 FD, (0.88 HRT on trained RVMs for AUROCS C Chiou C , To determine the diagnostic accuracy for classifying classifying for accuracy diagnostic the determine To 68 eyes of 68 healthy controls and 144 eyes of 144 glau 144 of eyes 144 and controls healthy 68 of eyes 68 RVMs trained on HRT data have higher diagnostic diagnostic higher have data HRT on trained RVMs 2 , RN Weinreb RN , 1

J Hao J , session 3: optic nerve head and nerve fiber imaging fiber nerve and head nerve optic 3: session 1 2 , Institute for Neural Computation, University University for Computation, Neural , Institute , VA San Diego Health Services Health , VA Diego San 2 L Racette L , 1 , MH Goldbaum MH , 1 L Zangwill LM , , 3 1, , PA Sample PA , 3 1 F Me FA , and/or 1 ------.

visual field sectors in the FDT and flicker perimetry. flicker FDT and the in sectors field visual corresponding anatomically the and NFLT the of sectors two between correlation significant was there However, perimetry. flicker and SAP,FDT the all in defects field NFLTvisual and average the between correlation significant no was there coma, glau of stage preperimetric the SAP.In for except field flicker and FDT the in points abnormal the of number the with lated (OAG). glaucoma of open-angle stages metric moto derived from STRATUS OCT with Standard automated perim automated derived from STRATUS Standard with OCT Kinki University School of Medicine, Osaka, Japan Osaka, Medicine, of School University Kinki etry (SAP), FDT and flicker field data in the early and preperi and early the in data field flicker and FDT (SAP), etry Changes In The Early And Preperimetric Stages Correlation Of The Structual And Functional CONCLUSION: RESULTS: METHODS: AND SUBJECTS PURPOSE: Matsumoto C of OAG. structure the with stages preperimetric and early the in by OCT obtained changes correlated significantly perimetry flicker Japan Osaka, of Medicine, School University Kinki Hospital Sakai Ophthalmology, clock hour sectors using STRATUS OCT. STRATUS using sectors hour clock the average nerve fiver layer (NFLT)thickness and NFLT in 12 with investigated was sectors field visual and field visual the of Correlation evaluated. was sector each in points abnormal the of number the and sectors 6 into divided were fields visual The 311. Octopus using 38S) (4-zone perimetry Flicker and 24-2-1), (24-2-5, Matrix FDT (SAP), threshold full HFA24-2 by tested OAGwere of stage preperimetric and -6dB) > (MD stage early Of Glaucoma 1 , E Arimura E , In the early stage of OAG, the average NFLT corre NFLT average the OAG, of stage early the In To investigate the correlation of structural findings findings structural of correlation the investigate To The functional changes obtained by FDT and and FDT by obtained changes functional The 2 1 , H Nomoto H , 2 , Y Shimomura Y , Seventy seven eyes of 77 patients with with patients 77 of eyes seven Seventy 1 , S Takada S , 1 . Department of Ophthalmology, Ophthalmology, of Department 1 , S Okuyama S , 1 , Department of of Department , 1 , S Hashi S ,

- - - - - FDR to 15% and 10%, respectively. The existing cut-off crite cut-off existing The respectively. 10%, and 15% to FDR the lower criteria confirmation and omitting The 25%. to 40% 88.5%, 80.8% and 73.1%, and respectively. 80.8% 88.5%, of rates true-positive had criteria confirmation and omitting ria, of8.1 follow-up to years]. 3.2 [range follow-up during criteria field by visual who progressed patients on hypertensive 52 ocular was quantified rate positive detection of follow-up 3.1 [range true- 7.9 The to controls matched years]. from patient was longitudinal quantified series in 20 age- normal FDR The strategy. confirmation a and strategy omitting an ing tify SIM ability to separate progressers from non-progressers. from progressers separate to ability SIM tify 67 Tomograph( Retina delberg alignment algorithm and techniques to lower the FDR includ FDR the lower to techniques image and new algorithm alignment a evaluates study This expected. than higher was the When chance. by the controls FDRwas applied technique age-matched to normal change detecting of likelihood the for to the of length the to patient according account series modified be may p-value global for the cut-off The non-progressers. from the across progressers separate to used is p-value change global The wholeimage. measures which p-value global a produces ‘change map’ areas of highlighting active change. The technique UK London, Detection Rate (FDR). Rate Detection CONCLUSION: RESULTS: METHODS: PURPOSE: BACKGROUND: UK London, Patterson AJ Series Of Optic Disc Images Detecting Structural Progression In Longitudinal eatet f poer ad iul cec, iy University, City Science, Visual and Optometry of Department SIM. SIM. The technique will now be tested on new to datasets quan in FDR the control to developed been Techniqueshave FDR. series ofseries optic nerve head images from (ONH) acquired the Hei in progression detect to adapted was technique The brain. the of images in activity of areas identify to neuroimaging in used ). To develop new methods to lower and control the False The new alignment algorithm lowered the FDR from from FDR the lowered algorithm alignment new The I i a uniaie ehiu wih eeae a generates which technique quantitative a is SIM 2 The new image alignment algorithm lowered the the lowered algorithm alignment image new The 1 , Glaucoma Research Unit, Moorfields Eye Hospital, Hospital, Eye Moorfields Unit, Research Glaucoma , Statistic Image Mapping (SIM) is MappingImage a (SIM) proven Statistic method 1 , DF Garway-Heath DF , Patterson et al IOVS 2005 46: 1659- 46: 2005 IOVS al et Patterson 6.07.12 0 0 2 2 , C Bergin C , 1 2:3p–4:05p 0 : 4 – 30p : 2 , David P Crabb P David , 27 1 - - - - .

abstracts session 3: optic nerve head and nerve fiber imaging 2 0 0 6.07.12 2:30p–4:05p abstracts session 3: optic nerve head and nerve fiber imaging

Longitudinal Evaluation Of Experimental Retinal Nerve Fiber Layer Defects By SLP, CSLO, And OCT

B Fortune, G Cull, L Wang, M Zeppieri, GA Cioffi. Discoveries in Sight, Portland, OR, USA

PURPOSE: To compare results from SLP, CSLO, and OCT before and after initiation of an experimental retinal nerve fiber layer defect (ERNFLD). METHODS: Four rhesus monkeys had retinal laser burns placed in an arc around the optic disc (~45° and 1.5 mm from the margin) to create an ERNFLD in one eye each. Baseline measurements of structure and function were obtained weekly for one month prior to, and 5 weeks after laser in both experimental and fellow con- trol eyes. Functional evaluation included multifocal, full field and pattern-reversal electroretinography (ERG). Structural evaluation included stereophotography, SLP (GDx VCC), CSLO (HRT1), and OCT (Stratus). RNFL thickness estimates were exported for a 3.4 mm diameter, circumpapillary locus from the CSLO and OCT instruments to match the “medium” locus of the SLP instrument; comparisons were made between instruments and over time before and after laser. RESULTS: During pre-laser baseline, RNFL thickness estimates were more consis- tent between sessions, and between right and left eyes for SLP and OCT as com- pared with CSLO. The average RNFL thickness was 45.9 ± 8.3, 95.4 ± 12.1, and 147.2 ± 30.7 for SLP, OCT, and CSLO respectively. One week after laser, a statisti- cally significant ERNFLD was present in 2/3 eyes by SLP and none by OCT or CSLO. Functional abnormalities were evident by multifocal ERG in 3/3 eyes (one experimental eye was omitted because of intraretinal hemorrhage). Between weeks 1 and 3, OCT estimates of RNFL increased, then declined in 3/3 eyes. CSLO never indicated any RNFL defect. session 3: optic nerve head and nerve fiber imaging CONCLUSIONS: In this small group of macaques, OCT provided the most reproducible estimate of RNFL thickness, closely followed by SLP. The CSLO estimates were relatively unreliable and insensitive. SLP detected the ERNFLD prior to OCT and CSLO, at a time when functional loss was apparent. The pattern of results suggests that OCT detected axonal swelling during early stage damage, but that birefringent elements were already disrupted. The discrepancies between SLP and OCT esti- mates may be informative about the pathological status of RGC axons. abstracts

28 reaction time ( time reaction perimeter (HAAG-STREIT Inc., Koeniz, Switzerland). For Switzerland). fur Inc., Koeniz, (HAAG-STREIT perimeter opnain i epoaoy y ad ed oeet addi tionally. movements head and eye exploratory via compensation consider to necessary with be may It patients conditions. VR of under HVFDs performance driving predicting in adequate ( and A-HVFD den Cor position. of head sity) and gaze under recording continuous cross-traffic of levels two with intersection an proaching giou ticipated in this study. this in ticipated Spearman’s by estimated were (A-SPAR) hemifield the affected within ofthe with area sparing time reaction (RT), with individual the area of the and the (A-HVFD), HVFDs with (NA) accidents of number the of relations ap of sequences (30 160° of angle viewing a covering projection screen a on presented tasks driving VR standardized onto superimposed digitally be could results perimetric analysis ther 10cd/m luminance background 3°/s, conditions. (VR) reality virtual understandardised accidents fic of traf frequency on the (HVFDs) defects field visual onymous FRG Tuebingen, of nath iul il (tmls I4 [6, 2 cd/m 320 [26’, III4e (stimulus field visual 90° the within perimetry kinetic semi-automated binocular by METHODS: PURPOSE: of University Neuroscience, Cognitive FRG of Tuebingen, Lab Zoology, of Dept. U Schiefer To What Extent Does Size And Location Of abstracts CONCLUSIONS: ( RESULTS: FRG Reality Driving Tasks Of Traffic Accidents? A Study Based On Virtual Homonymous Scotomas Influence The Frequency vascular brain lesions brain vascular with a ofacuity visual minimum par 16/20 unilateral to due HVFDs with years) 70 to 21 range age males; Tuebingen, FRG Tuebingen, r s =-0.12). 1,6 4 3 R Vonthein R , , Section of Neuropsychology, Dept. of Neurology, University University Neurology, of Dept. Neuropsychology, of Section , . etr f phlooy Uiest o Teign FRG Tuebingen, of University Opthalmology, of Center The number of accidents was with positively correlated To ofthe assess influence the size and location of hom Size and location of absolute HVFDs were assessed assessed were HVFDs absolute of location and Size 1 , G Hardiess Global perimetric findings findings perimetric Global r r 5 2 s ; EU-PERACT MEST-CT-2004-504321 s , Dept. of Neurology, Buerger Hospital, Stuttgart, Stuttgart, Hospital, Buerger Neurology, of Dept. , = 0.61). There was no correlation between NA between correlation no was 0.61). There = = 0.02) and likewise between NA = between and and 0.02) A-SPAR likewise 4 , Department of Medical Biometry, University of of University Biometry, Medical of Department , 5

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1 ------, Patients who failed the DVLA criteria Patients at who the 8 were DVLA failed years more criteria like 25%). (12, (CI) interval confidence 95% years, 8 at criteria VF in glaucoma. Br J Ophthalmol. 1998;82:1236-41. Br JOphthalmol. status glaucoma. in field visual binocular Simulating RA. Hitchings FW, Fitzke UK ing fastest, OR 3.6, 95% CI (1.9, CI 95% OR 3.6, 6.9). fastest, ing treatment. and sensitivity for initial controlling predictors, as years 3 at slopes IVF average ing us years 8 at failure DVLA predict to performed were analyses regression Logistic time. over sensitivities IVF mean of slopes regression linear from estimated was loss VF follow-up.of ning ocular Integrated Visual Field coma would(NTG) lose their driving licence because of progres UK London, pital, excluded if they had already failed these criteria at the begin the at criteria these failed already had they if excluded were Patients applied. were (DVLA) Agency VehicleLicensing and Driver UK the by used criteria VF binocular sensitivities, at right sensitivity each in location VF.the 24-2 Using these IVF left- maximum patient, the taking each by For constructed were IVFs clinic. binocular NTG Moorfields the from selected benefit from intervention. from benefit atof loss 3 follow-upyears might may that helppatients identify of follow-up. onbased rates Analysis of sensitivity IVF binocular 8 years after licence wouldNTG with patients lose driving their of proportion substantial blindness’.A to ‘milestone a resenting deteriorat eye the for sensitivity mean of slope the than failure DVLA of predictor better a was overtime sensitivity IVF mean of slope The years. 8 at criteria DVLA the passed who patients (2.7, CI OR6.1,than 95% 13.8) over time, sensitivity IVF mean deteriorating steeply more have (iii) (1.0,10.8); CI 95% 3.3, OR sensitivity, average initial lower have (ii) 1.7); (1.2, CI 95% (OR) 1.4, ratio odds estimated treatment, topical using be (i) to ly sive visual field (VF) defects after 8 years of follow-up, using bin Glaucoma And Fitness To Drive: 1. CONCLUSIONS: RESULTS: METHODS: PURPOSE: Owen VMF F Garway-Heath DF Predicting A ‘Milestone To Blindness’ rb D, iwnta A, cagt I Pioswy D, Poinoosawmy AI, McNaught AC, Viswanathan DP, Crabb 1 , Institute of Ophthalmology, London, UK London, Ophthalmology, of , Institute Of the 153 eligible patients, 27 (18%) failed the DVLA the (18%) 27 failed 153 patients, the eligible Of To determine which patients with normal tension glau l ptet wt a lat yas f olwu were follow-up of years 8 least at with patients All 1 D Crabb DP , Driving licence loss is a significant life event, rep life a significant is loss licence Driving 3 3 R Hitchings RA , 1 A Viswanathan AC , 1 (IVF) indices as early predictors. 3 , City University, London, London, University, City

2 , Moorfields Eye Hos Eye , Moorfields , 3 2, E White ET , 3 ------,

and fellow eyes (all p<0.05). fellowand eyes (all glaucomatous the between thresholds sensitivity the in with difference basis pointwise a on correlated was response BOLD the amplitude Furthermore, of of function. tests the three visual all for loss field visual of pattern the with agreed representation ucin FR o vsa ban ra i a oeta mas for means potential glaucoma. in neurodegeneration the a quantifying is areas brain visual of visual FMRI of function. loss the with consistent manner a in patients POAG at corresponding locations of V1. locations at corresponding responses wereonto basis fMRI scores a compared “pointwise” were computed for 12 and the test locations, difference resulting values (PD) deviation pattern between differences interocular Specifically, differ tests. function visual the interocular from thresholds in to ences compared dependent was level response oxygen fMRI (BOLD) blood resulting The checker pattern. flickering board a with eye each compared presenting were alternately eye by fellow vs. glaucomatous the through ing view to responses cortical Subsequently,V1. of representation flattened computationally a onto field visual the within regions project to used was template The template. a retinotopy with fit the was data and fMRI, using subject ob each in was V1 for space tained visual of map retinotopic A perimetry. (FDT) technology doubling frequency and (SWAP), perimetry mated tnad uoae prmty SP, hr-aeegh auto short-wavelength (SAP), perimetry automated standard using measured were defects imaging field Visual resonance experiment. magnetic (fMRI) functional this in (DIGS) participate Study to Glaucoma in Innovations Diagnostic the from glaucoma (POAG) and the functional organization of primary (V1). cortex primary visual of organization open-angle functional the primary and (POAG) human glaucoma in loss field visual of magnitude CONCLUSIONS: RESULTS: METHODS: PURPOSE: USA Diego, San California, of University Center, Glaucoma Zangwill. LM Weinreb, RN PA Sample, Duncan, RO Thresholds Cortex Correlates With The Pattern Of Visual Field Retinotopic Organization Of Human Primary Visual The spatial of pattern in observed activity the flattened To quantify the relationship between the pattern and and pattern the between relationship the To quantify Six subjects with asymmetric POAG were recruited recruited were POAG asymmetric with subjects Six h BL sga i hmn 1 s lee for altered is V1 human in signal BOLD The 6.07.12 0 0 2 4:2p–6p – 25p : 4 Hamilton Hamilton 9 2 - - - - -

abstracts session 4: innovative concepts 2 0 0 6.07.12 4:25p–6p abstracts session 4: innovative topics

The Frequency-Doubling Effect For Various Spatio- Sub-Layer Segmentation Analysis Of The Macular Relationship Between Fixation Status Evaluated Temporal Conditions OCT Scan Significantly Detects Damage In Unilat- With SLO Microperimetry And Critical Print Size eral Optic Neuropathy Before And After Photodynamic Therapy M Zeppieri, K Kent, S Demirel, CA Johnson. Discoveries in Sight, Devers Eye Institute, Portland, OR, USA R Kardon2B, VA Shah1A, M Haeker1B, MD Abramoff2A, M Sonka1C. Fujita K, Mori R, Mizutani Y, Kashiwakura S, Yuzawa M. Nihon AOphthalmology, BElectrical & Computer Engineering, CElectrical & University, Department of Ophthalmology, Tokyo, Japan PURPOSE: The ‘frequency-doubling’ illusion, in which the appar- Computer Engineering & Ophthalmology, 1University of Iowa, Iowa ent spatial frequency of a sinusoid grating appears to be doubled, City, IA; 2University of Iowa & Veterans Administration, Iowa City, IA PURPOSE: To evaluate the relationship of the position and light is produced when a low frequency spatial sinusoid grating is sensitivity of the fixation area with critical print size before and counterphased at a high temporal frequency. The current study INTRODUCTION: Structural optic nerve damage causing axon loss after photodynamic therapy (PDT) in patients with age-related examines the hypothesis of fractional increases in apparent spa- may be difficult to detect with coexisting optic nerve edema, or macular degeneration (AMD). tial frequency under particular spatio-temporal conditions. other causes of a thickened retinal nerve fiber layer. Sub-layer PATIENTS AND METHODS: Seven eyes with AMD were studied. METHODS: Detection contrast thresholds were determined and segmentation of the macula scan using optical coherence tomog- Before and 1 year after PDT, the position of fixation area and repeated in two observers for various spatio-temporal combi- raphy (OCT) may help to better define ganglion cell loss. light sensitivity were determined using scanning laser ophthal- nations of a counterphased sinusoidal grating. The perceived METHODS: Nine patients with chronic unilateral optic neuropathy moscopic microperimetry and critical print size was measured spatial frequency was then determined for each spatio-tempo- session 4: innovative concepts were tested by Stratus OCT3 (circular and macular fast scans) using MNREAD-J. ral combination using a matching task, whereby the periodicity and analyzed by both Stratus algorithm and by a novel segmen- RESULTS: The position of fixation area was unchanged in 5 eyes of a stationary sinusoid was matched to that of a counterphase tation image analysis technique to determine sub-layers of the flickered grating. The same matching task was repeated under and was shifted in 2 eyes 1 year after PDT. Pre-PDT light sen- retina. Boundaries were automatically determined in individual sitivity was 15 dB in 4 eyes, 20 dB in 2 eyes, and 25 dB in 1 eye; different matching task instructions for five randomly chosen scans and in composite scans (averaging of 6 scans into one im- spatio-temporal combinations. while post-PDT light sensitivity was less than 0 dB in 2 eyes, 0 age) using a graph-based cost function approach that utilized dB in 1 eye, 10 dB in 1 eye, 25 dB in 2 eyes, and 35 dB in 1 eye. RESULTS: No significant differences were found in test-retest edge/regional image information and a priori-determined con- In 2 eyes with less than 0 dB sensitivity, the fixation area was contrast threshold measures and under different matching task straints. Regional sub-layer analysis was also performed in four shifted toward the peripheral visual field. The change of light instructions. Match ratios were fractional, showing higher or patients with altitudinal visual field loss. sensitivity in the fixation area before and after PDT was evalu- lower apparent spatial frequencies by non-integer multiples. RESULTS: Significant differences between the affected and unaf- ated in 5 eyes, excluding 2 eyes that showed a shift in fixation CONCLUSIONS: The appearance of a variety of fractional spatial fected eyes were found with the inner sub-layer OCT macular area after PDT. Light sensitivity was improved in 3 eyes and distortions other than simply doubling provides additional evi- analysis (p=0.013) but not with total retinal thickness (p=0.111). worsened in 2 eyes. Critical print size (logMAR) was 0.40-1.20 dence that frequency-doubling illusion in humans is unlikely to Significant altitudinal differences in inner retinal sub-layer (mean: 0.71±0.28) before PDT and 0.30-1.40 (mean: 0.93±0.41) be solely generated by spatially non-linear Y-type magnocellular thickness (p=0.046) were found in eyes with corresponding 1 year after PDT. Critical print size was improved in 3 eyes, un- field loss. The two most significantly affected sub-layers cor- changed in 1 eye, and worsened in 3 eyes. Improved light sen- ganglion (My) cells, as previously reported. responded to the expected location of the retinal ganglion cells sitivity after PDT was associated with improved or unchanged and the most superficial nerve fiber layer. There was a signifi- critical print size. Worsened light sensitivity after PDT was as- cant linear correlation between the Stratus derived retinal layers sociated with worsened critical print size, and shift of fixation (retinal nerve fiber layer in the circular scans and total retinal area toward peripheral visual field was associated with worsened thickness) and our new segmenting algorithm. critical print size. CONCLUSIONS: The structural information in the sub-layer of the CONCLUSIONS: The position of fixation area and light sensitivity macular OCT scan corresponding to the location of retinal gan- at 1 year after PDT correlate with critical print size. glion cells and also the nerve fiber layer appears to have impor- tant potential for assessing optic nerve damage and could be par- abstracts ticularly useful when the retinal nerve fiber layer thickness in the circular scan does not correspond to the num- 30 ber of axons, as in case of optic disc edema. abstracts and visual field asymmetry in both the clinical and screening referral referral screening and clinical populations, the both in asymmetry field visual and referral both in was HRTfound between algorithm, to correlation exist A strong linear populations. population-based II HRT the negative-predictive than and values positive- specificity, sensitivity, higher much ures In Bexar County, Texas Parrish, Anderson (HPA) scoring criteria. Paired visual fields were fields segre visual Paired (HPA)criteria. Anderson scoring Parrish, Hodapp, to according loss glaucomatous 3) (level severe or 2), (level ate referred on the basis of FDT failure from in open the screenings commu being group one assessed; were populations clinical predominantly Mexican-American comparable, Two results. 24-2 SITA II Analyzer Field Visual Humphrey bilateral obtained concomitantly reliable and microns <50 bilaterally variability of available coefficients HRTs had All now III. HRT the in Coefficient) Product (Pearson algorithm asymmetry lar binocu intra-subject intrinsic new a using obtained algo values versus rithm scoring sectorial (population-based) Moorfields II HRT existing the using loss, field visual glaucomatous of absence or presence the ing predict for TomographII) (HRT Retina HeidelbergII the using tained USA CA, Dublin, Engineering, en severe glaucoma-type visual field loss. field visual severe glaucoma-type unilaterally with not but loss, field visual progressive bilateral with ated asymmetry III algorithm. HRT new the using reevaluated also were which from levels, category HPA 0/3) (i.e. images subjects, eyes of all 3 on both performed HRT was or II respectively. 1/3), 0/2, (i.e. 2 2/3), 1/2, or 0/1, R/L (i.e. L//R 1 by differing HVFs asymmetric V: and IV, III, categories asymmetry and 3/3), 2/2, 1/1, (i.e. abnormal symmetrically eyes both II: HPA levels 0/0), R/L (i.e. normal eyes both I: categories; five into gated moder 1), (level early 0), (level normal as fashion masked in classified was field visual each and 24-2, HVF bilateral reliable provided subjects optometrists. and by ophthalmologists clinic subspecialty a to suspects glaucoma as referred other the and nity, CONCLUSION: layer. fiber nerve the of symmetry bilateral normal VFL) severe eye other and normal eye (one V RESULTS: METHODS: PURPOSE: Sponsel WE Among Clinic Referral Patients And FDT Screening Fail Thickness To The Binocular Asymmetry Of HVF 24-2 Relationship Of Binocular Asymmetry In HRT NFL 1 . University of Texas Health Science Center, San Antonio, TX Antonio, San Center, Science Health Texas of University h nw nr-ujc HT I aymty loih gave algorithm asymmetry III HRT intra-subject new The To compare the positive and negative predicative values ob values predicative negative and positive the compare To 44 clinic referral patients and 97 positive FDT failure screening Remodelling of the peripapillary NFL appears to be associ be to NFL appears peripapillary of the Remodelling 1 with one very pronounced exception in both groups: the category category the groups: both in exception pronounced very one with , M Sinai M ,

2 session 4: innovative topics innovative 4: session , Y TrigoY , 2 1 , J Hendricks J , 1 , GC Lindhorst GC , HVF pairs demonstrated demonstrated pairs HVF 1 , Heidelberg Heidelberg , 1 , L Nguy L , ------is not related to the number of IPS members. of number IPS the to not related is However, publications in of our meetings. increase the portance im the reflect may publications of rate the of fluctuation nual rimetry. paper, and, c) the paper focuses on perimetry. focuses paper the c) paper, and, the of topic main the not was perimetry b) mentioned least at was term the a) where publications or number a render would as b) ‘majortopic’. as This stored, term MeSH as ‘topic’, c) and, term field MeSH any in a) ‘perimetry’ term the for searched publications /year. publications 58.3 51.2 versus or, 874publications, 819 i.e., versus years, even in than odd in published was research topic’ ‘major less cantly Library Of Medicine Publications On Perimetry Listed In The National CONCLUSION: RESULTS: METHODS: PURPOSE: Basel Clinic, Eye University &CCastelberg, M Zulauf perimetry to all clinical papers published. The observed bian observed The published. papers clinical all to perimetry on publications of number presented the compare to have will studies Further increasing. is interest this numbers, absolute In For 1975 signifi the that years it odd rather to learn, was – 2005, lately. increase to seems and years 20 for steady remains 1980, till increased publications of rate the i.e., decade, per 76.8 and, 58.9, 50.5, 23.3, 16.6, averaged presentations of number annual The presented: are topic’‘major as perimetry with publications the only simplicity, of sake For the synchrony. strict in increase numbers the years, the Over published. have been respectively, 1960-1964. For the three groups, a published of total 5010, 4233, publications and, 1882 publications 138 excluding 2005 – 1965 on headings report our 1965. We limit since therefore subject known are (MeSH) Furthermore, 60s. early the in NLM the by werecovered publications all not i.e., error, sampling a probably 39,54, for196054 and, the years – 1969. is sudden This increase The The number of is 10,retrieved articles 13, 17, 43, 36, 44, The National Library of Medicine (NLM) was was (NLM) Medicine of Library National The To evaluate if there is still a scientific interest in pe in interest scientific a still is there if To evaluate Perimetry as a scientific subject is still of interest. interest. of still is subject scientific a as Perimetry - - - - unselected glaucoma populations. glaucoma unselected in progression of extent the underestimate glaucoma of studies Longitudinal glaucoma. in progression of extent the upon fects ef significant have to likely is therapy with compliance proved Im studies. longitudinal a in enrolled patients in loss field sual therapy. their with compliant more be to likely are and condition their with engaged more are studies tudinal longi in particpate to voluteering patients Those bias. lection se to due be to believed is difference This study. longitudinal prospective a in enrolled not eyes the in higher times 4 mately change and the relative risk of forprogression a of series progres measure to used was indices field visual global of regression ear study Lin Hospital. Eye longitudinal Royal Manchester same of population outpatient the from drawn were samples Both loss. field visual of pattern spatial and extent the 3) and low-up sion criteria. matched on the basis of 1) time of enrollment, 2) length of fol of length 2) wereenrollment, of Eyestime 1) of basis studies. the on matched any in enrolled not patients from to eyes matched 66 were study longitudinal prospective a in enrolled longitudinal study versus those not enrolled in astudy. in not enrolled those versus study longitudinal prospective a in enrolled eyes glaucomatous of sample a in loss CONCLUSIONS: RESULTS: METHODS: PURPOSE: Kingdom United Manchester, Shambhu. S Henson, DB In A Prospective Longitudinal Study Field Loss In Patients Enrolled And Not Enrolled Relative Risk Of Progressive Glaucomatous Visual The risk of progressive visual field loss was approxi was loss field visual progressive of risk The To field the relative of visual risk progressive establish The first visual field records of 66 glaucomatous eyes glaucomatous 66 of records field visual first The Selection bias reduces the risk of progressive vi progressive of risk the reduces bias Selection Ophthalmology, Manchester University, University, Manchester Ophthalmology, 6.07.12 0 0 2 4:2p–6p – 25p : 4 31 ------

abstracts session 4: innovative concepts 2 0 0 6.07.13 8a–11:00a abstracts session 5: imaging to assess optic nerve head susceptibility – connective tissues, blood supply and metabolism

Three Dimensional Optic Nerve Head (ONH) ONH biomechanics: what’s important to measure Preclinical Changes In Optic Disc Topography In Anatomy – Target Structures And Target Measure- and why? Ocular Hypertensive Patients ments For Clinical Imaging JC Downs1, I Sigal2. Devers Eye Institute, Portland, OR, USA1. BC Chauhan. Department of Ophthalmology and Visual Sciences, C Burgoyne. Discoveries in Sight, Devers Eye Institute, Portland, University of Toronto, Toronto, Canada2 Dalhousie University, Halifax, Nova Scotia, Canada OR, USA. PURPOSE: The biomechanical environment within the optic The observation of optic disc changes without corresponding Digital 3D reconstructions of 600 to 1200 serial histologic sec- nerve head (ONH) is believed to play a role in the pathogen- visual field changes in patients with ocular hypertension sug- tion images (3.0 or 1.5 micron voxel resolution) from the ONH esis of glaucomatous optic neuropathy. We describe the use of gest either that visual field techniques are not sensitive to the of both eyes of 20 Normal, 12 Early Glaucoma, 8 Moderate Glau- computational models of the ONH to identify the factors that earliest losses or that the changes that are occurring structurally coma and 8 Ischemic (endothelin) monkeys are being processed influence ONH biomechanics and contribute to an individual’s do not have a neuronal component. Modern imaging techniques for 3D delineation of neural canal, prelaminar, laminar, retrolam- susceptibility to elevated IOP. have the potential of documenting both the frequency and mag- inar, and peripapillary scleral macro and micro-architecture. For nitude of these changes as images can be captured without pupil METHODS: Biomechanical models of the ONH were created and each ONH, 40 serial, digital, radial, sagittal sections of the re- dilation and with a higher frequency. The digital nature of the used to simulate the ONH biomechanical response to changes construction (4.5 degree intervals) are sampled and within each data also allow application of powerful analytical and statistical in IOP. Several families of models were studied, which varied the following landmarks and structures are identified: internal tools. in species, geometric complexity, scale, and material properties. limiting membrane of the retina, Bruchs Membrane, anterior Geometrically, human and monkey ONH models varied from Over the last 4 years we have been collecting optic disc topog- scleral and laminar surface, posterior scleral and laminar surface, generic (parametric) to individual-specific. Scale and complex- raphy images with the Heidelberg Retina Tomograph in pa- central retinal vessels, inner surface of dural sheath, outer sur- ity varied from models including the whole posterior pole to tients with ocular hypertension. The objective of this study is face of pial sheath, neural boundary, Bruchs Membrane opening those that focus on a few trabeculae within the lamina cribrosa. to carefully document the frequency and extent of subclinical (BMO), anterior scleral canal opening, anterior laminar beam in- Applied material properties varied from linearly elastic and iso- (i.e. without visual field damage) disc changes in ocular hyper- sertion, posterior laminar beam insertion, posterior scleral canal tropic to orthotropic. Biomechanical response was quantified tension using the Topographical Change Analysis. Patients are opening and anterior most extent of the subarachnoid space. To through displacement, mechanical stress (local forces), and me- tested every 3 months for the first year and then every 4 months clinically visualize and orient these structures, the delineated chanical strain (local deformation). thereafter. points along with the central retinal vessel reconstructions are overlaid on clinical stereophotos. To quantify the delineated RESULTS: At elevated IOP, the tissues of the ONH are subjected This presentation will review the study methodology, analysis structures, a zero-reference plane (BMO zero-reference plane) to various modes of strain that are likely to be biologically sig- techniques and results. is fitted to the 80 Bruch’s membrane opening points (40 sections nificant. In all human models the geometry and material prop- each with 2 BMO points) which is the clinically-visible entrance erties of the sclera had the largest influence on ONH biome- to the neural canal (defined to extend from Bruchs membrane chanics while in the monkey models, regional laminar density opening to the posterior scleral canal opening). Separate strate- and predominant trabecular orientation had a large effect. The gies for 3D quantification of neural canal, prelaminar, laminar, microstructural models of the monkey lamina showed stresses in session 5: imaging to assess optic nerve head susceptibilityand peripapillary scleral macro and micro-architecture have individual laminar beams of 10-100 x IOP. been developed. Within each monkey, statistical and visual (by CONCLUSIONS: Although the physiologic effects of connective digitally inverting the left eye reconstruction to a pseudo-right tissue stress and strain in the ONH need further investigation, eye orientation, then overlaying the inverted-left and right eye biomechanical models of the posterior pole and ONH provide reconstructions) comparison of the right and left eyes are possi- insight into the likely sites and modes of IOP-related ONH ble. Within representative reconstructions, the clinical implica- connective tissue damage. Preliminary results suggest that the tions of Bruchs membrane opening, the neural canal landmarks, geometries and material properties of the peripapillary sclera neural canal obliqueness, the peripapillary scleral flange, lami- and lamina cribrosa likely predict an individual’s susceptibility nar and peripapillary scleral thickness and laminar microarchi- abstracts to IOP-related tissue damage and glaucomatous loss of vision. tecture will be emphasized. Once this is shown in more sophisticated models, imaging tech- nologies should be developed to measure these factors in vivo, allowing for a clinical evaluation of an individual’s susceptibility 32 to IOP, and an associated safe target IOP. – – abstracts models are based. are models these which on diseases the of treatments potential monitor and tigate inves optimally to tool a provide to as so imaging, with models these of assessment objective for demand greater even an nowadays is there that or However,chemically. means use surgically to reproduce their difficult is which disease chronic of model accurate more much a provide models These used. increasingly being now are glaucoma of Transgenicmodels studies. longitudinal in structure, ONH multi-layered the of analysis structural detailed form non-invasive methods to monitor changes in the retina & ONH ONH & retina the in changes monitor to methods non-invasive use to possible is it means now devices imaging of power and resolution increased However, the eyes. mouse and rat of size small the the and optics to due primarily is This models. rodent to applied be to able been of measurements human ONH, until recently, have these techniques not objective allow that techniques imaging in advances many the Despite ONH. glaucomatous rat in body.increased the significantly is TGF-ß2, that shown have throughout others We and response healing the in regulator key a is which TGF-ß factor ofgrowth the production the be to believed is major factor blasts at these sites has been as identified bybeing affected IOP.raised A UK London thalmology, changes in extracellular matrix constituents such as collagen I, III and and laminar/fibro and IV, III TGF-ß2, of MMP-1.astrocytes activation I, Cellular collagen as such constituents matrix extracellular in changes including tissue connective the of remodelling extensive demonstrated have studies These damage. of glaucomatous site primary a as ONH the confirming human, the of that to similar be to shown been have disease experimental in (ONH) head nerve optic rat the in Changes glaucoma. for tool studying a as useful recognised The rodent model is increasingly F Cordeiro Models Of Glaucoma Imaging The Optic Nerve Head In Experimental Rodent strategies for this disease. We have recently shown it is possible to per to possible is it shown recently have We disease. this for strategies and therapies new assessing when data objective for need real a is there and glaucoma, experimental in prerequisite canal important an scleral are expansion or cupping ONH of measurements precise example, For 1 , F Fitzke

2 session 5: imaging to assess optic nerve head susceptibility head nerve optic assess to imaging 5: session . 1 connective tissues, blood supply and metabolism and supply blood tissues, connective Western Eye Hospital London, UCL Institute of Oph UCL Institute London, Eye Hospital Western and UCL Institute of Ophthalmology, London UK London Ophthalmology, of UCL Institute and in vivo in 2 - - - - . tures with Doppler Fd-OCT will be also be demonstrated. be also be will DopplerFd-OCT with tures struc retinal in flow Doppler map to ability The presented. be will controls age-matched and neuropathies optic with patients between comparisons Some interest. of structures quantify to used been has software segmentation and visualization Custom AO-OCT. for resolution) 3D high (with µm 100 250 x µm and 300 x µm OCT alone stand for mm 2 x mm 6 x mm 6 covering structures retinal of sets data volumetric acquire to it possible is instruments, Fd-OCT both of speed high the to Due copy. described previously OCT,as but commercial on evident layer continuous nerve the than unmyelinated rather of fibers bundles stratified revealed has OCT AO- retinae. individual within function of reduction with retinal correlates drop-out cone of extent The cones. missing of areas with irregular look mosaic photoreceptor the making hence tors 2 (2) Fou proximately photographs, µm resolution lateral retinal ments. Both AO instruments reveal losses of cone photorecep cone of losses reveal instruments AO Both ments. that have structures not instru with commercial been visualized head nerve optic and retinal reveal results Our resolution. µm) (6 high-axial and µm) (3.5 high-lateral both - in result FdOCTAOto (3) and resolution, lateral µm 6 15 or and resolution 4.5 ~3, axial µm either with B-scans frames/sec) (9-36 speed high providing (Fd-OCT) tomography coherence optical rier-domain Nerve Head Changes In Optic Neuropathies High-Resolution Imaging Of Retinal And Optic S enr S Co, J aazi J Keltner. JL Zawadzki, RJ Choi, SS Werner, JS dpie pis A) lo-luiain hc rsls n ap in results which flood-illumination (AO) optics adaptive (1) included: instruments These laboratory. our in constructed instruments bench-top three, with imaged been have normals age-matched and neuropathies optic of variety a with Patients CA Sacramento, Davis, Calif., of Univ. Ophthalmology, with electron micros electron with vitro in Department of of Department ------

were obtained first in the dark state (D) and subsequently dur subsequently and (D) state dark the in first obtained were maps metabolic resolution spatial high technique, the of variant ment of new strategies to retard disease progression. disease retard develop to ment of new strategies the allowing thereby disease of stages earliest the at intervention therapeutic of possibility exciting the presents ogy light (L). L ing and flickered D maps were and subtract aligned cits defi functional revealed mapping OHT,metabolic and POAG severe to moderate in HRTII and OCT by disc the at revealed deficits with spatially correlate measurements though metabolic function prior to cell apoptosis. This novel functional technol functional novel This apoptosis. cell to prior function ofcompromised the detection allow may mapping in metabolic retina, function image to time first the for ability the of virtue By technologies. structural by revealed damage irreversible the precede may that deficits functional reveal perimetry objective and mapping Metabolic fibers. these input that photoreceptors of density the and fibers nerve retinal of known distribution the anatomic with consistent data revealed perimetry objective trend this reversed and mapping Metabolic retina. temporal the of stimulation dominance with light while side, nasal the to compared rim neuroretinal temporal and retina temporal the in D) of the lowerhuman In retina. darkness, values were observed ed maps pixel-by-pixel (L- to yield objective perimetric the first ise eaoim y 72% / 1.9 (lbl vrg) Al average). (global 13.49% +/- 67.21% by metabolism tissue retinal depresses OHT models animal primate In MD). POAG dB of (-3 stages earliest the detect to technique the of ability the demonstrate that presented be will retinal maps Metabolic in tissue. spatially mitochondria within dinucleotide adenine flavin of anisotropy fluorescence of measurement upon based retina the of imaging functional allows that technology optical non-invasive, novel a present I prior glaucomas. the die of fibers detection nerve to retinal of 30-50% that known well is It PA Philadelphia, Imaging, Biometric R Zuckerman. And Primary Open Angle Glaucoma Function In Retinal Tissue In Ocular Hypertension Death: Non-Invasive Imaging Of Mitochondrial Detecting Functional Compromise Prior To Cell ≈ 40% that 40% are evident in mild POAG, prior to cell death. In a 6.07.13 0 0 2 8a–1 a 0 0 –11: a 8 33 ------

abstracts session 5: imaging to assess optic nerve head susceptibility 2 0 0 6.07.13 8a–10:45a abstracts session 5: imaging to assess optic nerve head susceptibility – connective tissues, blood supply and metabolism

High-Speed Ultra-High Resolution OCT – In Vivo Oxygenation Maps Of The Glaucomatous Our Experience With The ONH Optic Nerve Head By Hyperspectral Imaging

J Fujimoto. Department of Electrical Engineering and Computer AMG Baptista1, DB Henson1, DH Foster2. 1Faculty of Life Science, Science, Research Laboratory of Electronics, Massachusetts Institute University of Manchester, Manchester, United Kingdom; 2Faculty of of Technology Engineering and Physical Sciences, University of Manchester, Man- chester, United Kingdom Optical coherence tomography (OCT) was developed in 1991 and is rapidly gaining acceptance as a standard diagnostic im- PURPOSE: The purpose of this pilot study was to establish wheth- aging tool in ophthalmology. OCT is analogous to ultrasound er hyperspectral imaging can reveal changes in the oxygenation imaging, except that it generates images by measuring the echo at the optic nerve head (ONH) in patients with diagnosed glau- time delay of light. OCT is especially powerful in ophthalmolo- coma that includes structural changes to the ONH. gy because it provides real time, non-contact cross sectional im- aging of the retina or the anterior eye at unprecedented resolu- METHODS: Imaging of the ONH was achieved with a special- tion. Recently, there have been exciting research developments purpose hyperspectral camera. The ONH was illuminated se- in OCT technology. Ultrahigh resolution OCT (UHR-OCT) quentially over the range 545-585 nm in steps of 5 nm by light imaging with axial resolutions of ~3 um, approximately 3-4x fin- from a xenon lamp filtered by a fast tunable liquid-crystal filter er than standard OCT, significantly improves the visualization (VariSpec, VS-VIS2-10-HC-35-SQ, Cambridge Research & In- of retinal morphology. UHR-OCT enables real time visualiza- strumentation). The spectral images were acquired in about 6 tion and quantification of internal retinal structure such as the sec with a low-noise Peltier-cooled digital camera (Hamamatsu, gangalion cell layer or inner and outer segments of the photore- model C4742-95-12ER) with a spatial resolution of 672 x 512 ceptors. The ability to visualize the photoreceptor morphology pixels. The ONH of 15 controls and 15 glaucomatous patients and its impairment is a promising marker of disease progression. were imaged with this system. Oxygenation index as a func- In addition, there have been dramatic increases in OCT imaging tion of the location at the ONH was assessed from amplitudes speed, ~50 to 100x faster than standard OCT. These new OCT of the haemoglobin spectral signature contained in the reflec- detection techniques are known as Fourier/spectral detection tance spectra derived from the images. The oxygenation indices because echo time delays are measured by Fourier transforming were plotted in a two-dimension map. Structural and functional the interference spectrum of the light signal. It is now possible measurements of the ONH were obtained, respectively, with to acquire high definition OCT images with much higher axial a confocal scanning laser ophthalmoscope (Heidelberg Retinal scan densities in a fraction of the time previously required. Eye Tomograph) and a visual-fields analyzer (Zeiss-Humphrey). For motion artifacts are greatly reduced and it is possible to mea- each eye the oxygenation map was compared with the structural sure the true retinal or optic nerve head contour. High speed and functional results. session 5: imaging to assess optic nerve head susceptibilityimaging enables comprehensive coverage of the retina, reduc- RESULTS: The controls’ maps revealed a large inter-subject vari- ing sampling errors which can miss focal pathologies. Finally, ability mainly due to differences in ONH topographies. Glauco- 3D-OCT data sets can be acquire which enable the generation matous patients’ maps revealed poorer oxygenation of sectors in of OCT fundus images as well as rendering and three dimen- which there was already evidence of neural and functional loss. sional visualization methods similar to those used in MR imag- ing. While still in the research phase, these advance promise to CONCLUSIONS: The present study quantitatively confirmed greatly enhance the performance of OCT for retinal and optic poorer oxygenation in neural tissues with established structural nerve head imaging. changes resulting from glaucoma. abstracts

3 4 average DVF response time from 1.1 to 6.0 seconds. Compari seconds. 6.0 to 1.1 from time response DVF average and logcontrast, 1.75 to 0.10 from sensitivity contrast logMAR, DVF was significantly related to NEI-VFQ scores while stan while scores NEI-VFQ to related significantly was DVF as important be may loss field visual movements central Eyefor compensate to diabetics. older in loss field amount visual the central of overestimating significantly be may instruments VFQ scores in older diabetics. in scores VFQ was tivity found to be most with overall strongly associated NEI- sensi contrast as function everyday in loss important vision more be may Contrast not. were results field visual central dard p order; (in times response DVF average and acuity, visual sensitivity, trast con for significance found score NEI-VFQoverall on variables 50%). and (69% Single of variable regression analysis the independent errors vision loss positive false of rates high had Matrix HFA and the both that Note 0.34). ((+ 0.50 (+= 0.69 specificity = 0.38), sensitivity found SLO to Matrix and 0.34) (+ 0.31 = specificity 0.77(+0.40), = sensitivity found HFA of SLO son to NEI-VFQ. on the score overall the to results and results function other visual instrument perimetry these by assessed loss vision between associations the tigating perimetry instruments (SLO, HFA, and Matrix), and 2) inves 2) and Matrix), and HFA, (SLO, instruments three perimetry from loss field visual central of results the comparing 1) living. daily of activities assessed survey self-report question 25 VFQ NEI- The monocularly. field visual central assessed perimetry (24-2) HFAand Matrix SLO (hybrid center). perimetry), (24-2), the to (relative target the of direction the indicated subject the until on left were targets The field. visual the scanned subjects fields visual dynamic and (DVFs). DVFs were while found bytargets presenting randomly sensitivity, contrast acuity, by assessed visual loss vision binocular had diabetes) of onset since CONCLUSIONS: RESULTS: METHODS: PURPOSE: Excellence of Center Bengtzen. AR Schuchard, RA Everyday Function In Older Diabetics Comparison Of Visual Fields And Vision Loss On abstracts Testing results found visual acuity from -0.14 to 1.44 1.44 to -0.14 from acuity visual found results Testing This pilot study investigated diabetic vision loss by: by: loss vision diabetic investigated study pilot This Fifteen older diabetic subjects (at least 50 yo, 5 years years 5 yo, 50 least (at subjects diabetic older Fifteen ≤ 0.05). High false positive rates from standard perimetry perimetry standard from rates positive false High

session 6: clinical perimetry II perimetry 6: clinical session Atlanta VA Rehabilitation R&D R&D Rehabilitation VA Atlanta - - - - - F rsls n ae V, aua tikes r es transpar lens or thickness macular VA, age, between and results correlations RFT significant no were There retinopathy. diabetic mild a had subject One observed. were maculopathy or thickening retinal opacity, lens of signs no eyes these In eyes. damage in patients with diabetes. with patients retinal in damage subclinical detect to (RFT) Test Fovea Rarebit the of implications are currently investigated. currently are implications therapeutic potentially and prognostic The methods. screening and tests conventional from findings to uncorrelated diabetes, with a subgroup of in patients function about macular formation ency. of 100-97%. range anormal with targets seen percent i.e. rate, hit as expressed are results the and dots bright small very are stimuli The degrees. 4 central the within fovea Test of probes architecture the integrity retinal (RFT) Rarebit photography. The Scheimpflug using transparency lens of determination and thickness retinal macula the of surement mea OCT scale, grading a using photography, analyzed fundus ing VAmeasurement, refraction using testing the ETDRS chart, includ examination extensive an underwent patients All 6D. ± within VA and refraction a 0.0 or better of corrected logMAR best changes, vascular or macular known no were criteria clusion Sweden Stockholm, Hospital, Eye Erik’s St tet, Institu Karolinska Vision, and Ophthalmology of Section roscience, years (mean 40.5±9.6 years), and with a duration of diabetes diabetes in of The examined. 10.9±7.4were duration (mean SD) years 29 to a 1 from with and years), 40.5±9.6 (mean years Rarebit Fovea Test In Diabetes CONCLUSION: CONCLUSION: RESULTS: METHODS: PURPOSE: Martin. Wendt,vonL G Nilsson, M Abnormal hit rate (50-96%) was found in 14 of the 42 the of 14 in found was (50-96%) rate hit Abnormal Forty-two eyes from 42 diabetic subjects, aged 18-55 18-55 aged subjects, diabetic 42 from eyes Forty-two The aim of this pilot study was to evaluate the ability ability the evaluate to was study pilot this of aim The h fnig idct ta RT a poie in provide may RFT that indicate findings The Department of Clinical Neu Clinical of Department ------h mtmrhpi soe sn MCAT™ I te meta the If M-CHARTS™. using score metamorphopsia the and questionnaire our using perception metamorphopsia the of Findings With Subjective Perception Of Metamor Sakai Hospital Kinki University School of Medicine, Osaka, Japan Osaka, Medicine, of School University Kinki Hospital Sakai phopsia In Patients With Macular Diseases phopsia as compared with PHP™. with compared as phopsia AMD. in 76% by M-CHARTS™ by in 69% ERM, PHP™ and by PHP™, by 78% M-CHARTS™ % 38 was metamorphopsia detecting for sensitivity The ERM. was tionnaire in observed patients with MH and AMD than with ques our using perception metamorphopsia subjective severe groups, disease 3 all in same the about were scores morphopsia hole and (MH) macular 18 eyes of 18 degen age macular related 38 of 20 eyes membrane (ERM), of 20 idiopathic epiretinal eyes idiopathic 38 in methods three these compared We acuity function. hyper PHP™ the using metamorphopsia M-CHARTS™. detect to by designed is measured was metamorphopsia detect to needed line dotted the of angle visual minimum the metamorphopsia, of qualification the For life. daily in phopsia metamor of perception subjective the of severity the evaluated morphopsia in the of quality vision. Usingwe this questionnaire, findings. PHP™ and by M-CHARTS™ obtained score metamorphopsia the with it compared and metamorphopsia of patient’sseverity the subjective evaluating for questionnaire sia metamorphop new a designed study,we this In life. daily their the patient’s reflect in of subjective perception metamorphopsia score and byobtained PHP™ can M-CHARTS™ really findings metamorphopsia the if clear not still However, is it AMD. of sia metamorphop the detecting for developed also was PHP™ es. da eration (AMD) patients. (AMD) eration metamorphopsia and reported its usefulness for macular diseas for macular usefulness its reported and metamorphopsia CONCLUSION: RESULTS: METHODS: AND SUBJECTS PURPOSE: Arimura E Correlation Of M-CHARTS™ And PHP™ Osaka, Japan Osaka, Medicine, of School University Kinki Ophthalmology, of Department aua dsae. -HRS cn eet lgt metamor slight detect can M-CHARTS™ diseases. macular with patients in metamorphopsia of perception subjective the otis 0 usin wih ou o te ypos f meta of symptoms the on focus which questions 10 contains 2 , S Okuyama S , There was significant correlation between the severity severity the between correlation significant was There We for of developedthe quantification M-CHARTS™ 1 , C Matsumoto C , Metamorphopsia score by M-CHARTS™ reflects reflects M-CHARTS™ by score Metamorphopsia 2 2 , Y Shimomura Y , Our new metamorphopsia questionnaire questionnaire metamorphopsia new Our 2 , H Nomoto H , 2 . Department of Ophthalmology, Ophthalmology, of Department 6.07.14 0 0 2 2 , S Hashimoto S , 8a–9:35a : 9 – a 8

2 , S TakaS , - 1 ------,

abstracts session 6: clinical perimetry II 2 0 0 6.07.14 8a–9:35a abstracts session 6: clinical perimetry II

Automated Static Perimetry In Eyes With Central Full Threshold Perimetry In Normal Afro-Ameri- Low Spatial Frequency Contrast Sensitivity Deficits Serous Chorioretinopathy cans And Caucasians In Magnocellular And Parvocellular Pathways In Glaucoma H Iijima. University of Yamanashi, Yamanashi, Japan JC Merritt. Hoerbal Eye Health, Clinton, NC, USA AM McKendrick1, G Sampson1, DR Badcock2. University of Mel- PURPOSE: To study the central visual field abnormality seen in PURPOSE: To determine mean sensitivities (MS) in normal Afro- bourne, Australia1. University of Western Australia, Perth, Australia2 eyes with central serous chorioretinopathy (CSC), which has Americans (AA) and Caucasians (C) in rural North Carolina. rarely been evaluated quantitatively using automated static pe- METHODS: 110 subjects had full threshold strategy (G1X program) PURPOSE: Early glaucomatous damage may result in pruning rimetry in a clinical study. The author claims that the severity performed using the Octopus 1-2-3 perimeter (Haag Streit, or loss of larger ganglion cells [1]. This study uses a recently of the disease should be assessed by the mean deviation (MD) Berne, Switzerland) from June1999 to May 2001. Subjects were described technique to measure low spatial frequency sensitiv- of the central 10-degree automated static perimetry, which is identified as normal after complete eye exam (with IOP<22 ity in parvocellular pathways. We aimed to determine whether independent of the visual acuity. mmHg) and the exclusion of the complete Metabolic Syndrome greater sensitivity loss exists at lower than medium spatial fre- METHODS: We reviewed the results of Humphrey perimetry, cen- (central obesity, hypertension, dyslipidemia, increased fasting quencies in presumed magnocellular (M) and parvocellular (P) tral 10-2 program taken for 121 eyes of 118 patients (22 female glucose and triglycerides). Hypertensive subjects on therapy processing. and 96 male) with CSC seen in our hospital between 1993 and were included. There were 66 AA (ages 20-29, n=32 and ages METHODS: Thirteen individuals with early glaucoma (aged 52- 2003. A total of 132 episodes of serous retinal detachment (98 50-59, n=34). There were 44 Caucasians (ages 20-29, n=23 and 84 years) and 14 age-similar controls (53-77 years) participated. session 6: clinical perimetry II initial and 34 recurrent) was studied. In order to study the ef- 50-59, n=21). No subject had been previously tested with full Contrast sensitivity was measured using gabor stimuli (Gaussian fects of active serous retinal detachment on the central visual threshold perimetry; hence the Octopus 1-2-3 (TOP) program modulated sinusoids of 0.25, 0.5, 1 and 2 c/ , stdev of Gauss- field, eyes with obvious RPE atrophy evidenced by the angio- was used as initial experience to maximize perimetric learning ° ian 4°). These were presented using both a steady pedestal graphic window defects were excluded. curves. All subjects resided within rural eastern North Carolina paradigm (40ms presentation of the gabor against a continuously (Sampson County). RESULTS: Central visual field abnormality in eyes with CSC var- presented luminance pedestal) and a pulsed pedestal paradigm ied from no defects to severe and large central scotoma. Mean RESULTS: In AA eyes (n=132) the mean sensitivity (±SD) was (40ms presentation of the gabor and pedestal). The steady and deviation (MD) ranged from –21.1 dB to 2.6 dB with the mean 28.1 ±1.3dB (age 20) and 26.8 ± 1.4dB (age 60), slope –0.034. pulsed pedestal gabors permit determination of spatial fre- of –3.8 dB. Thirty seven of 132 perimetric results (28%) showed The MS in Caucasian eyes (n=88) was 28.1 ±1.1dB (age 20) and quency dependent deficits of M and P pathways respectively MD lower than –5 dB. The best corrected visual acuity ranged 27.1 ± 1.4dB (age 60), slope –0.025. The 95% confidence inter- [2]. Contrast sensitivity was measured foveally, and at two mid- between 0.07 and 1.5 with the median of 0.7. The correlation vals of these slopes overlap, hence no differences exist. Both peripheral locations (10°). For each subject, one mid-peripheral between MD and logarithm of minimum angle of resolution groups lose 0.3dB/decade. Test times for the G1X were 10 ± 0.6 location was within a quadrant of normal visual field (Standard (logMAR) was not significant (r = -0.116, P = .186) implying that minutes in AA and 10 ± 0.7 minutes in Caucasians. Automated Perimetry, Medmont M700) with the other location the severity of central field defects could not be predicted from being presented in a quadrant of early field loss. CONCLUSIONS: The MS is the same in Afro-Americans and Cau- the visual acuity. casians. Full threshold strategies (G1X program) must become a RESULTS: Glaucoma group performance was not significantly dif- CONCLUSION: Eyes with CSC show various degrees of central primary preventive tool to reducing glaucoma blindness in high- ferent from controls for either pedestal procedure when tested visual field loss. Poor correlation between MD and corrected risk groups (AA) and to eliminate unnecessary medical, surgical foveally or mid-peripherally within an area of normal visual visual acuity implies that many eyes with CSC showing near and laser therapies in glaucoma suspects. field. Within a quadrant of early visual field loss, the glaucoma normal visual acuity may suffer from severe central visual field group had significantly reduced sensitivity of both presumed M abnormality. Automated static perimetry measuring the central and P processing (steady: F(25,1) = 23.01, p<0.05; pulsed: F(25, 10-degree visual field in an eye with CSC provides additional 1) = 11.50, p<0.05). Effect sizes demonstrated that the sensitivity information for assessing visual disability that could not be pre- loss was of a similar magnitude for all tested spatial frequencies. dicted by visual acuity testing. CONCLUSIONS: This study shows non-selective loss of sensitiv- ity in both M and P pathways for stimuli of low-medium spa- abstracts tial frequency. Testing P function may be equally as effective as testing M function for the detection of early visual field loss in glaucoma. 36 [1] Glovinsky et al. IOVS. 1991: 32: 484-91 [2] Leonova et al. Vis. Res. 2003: 43: 2133-9 mean IOP of follow-up was used for the assessment ofIOPcon assessment forthe IOPoffollow-upused was mean The medications. antiglaucoma topical for with up years 2 followed than more were patients All study. the in enrolled were IOP lowering would be expected to be beneficial in patients patients in progression. of disease who have risk the NTG with beneficial be to expected be would lowering IOP of treatment of satisfactory and disorders circulation of istence (p<0.02). arrhythmia and Raynaud’s phenomenon (p<0.01), (p<0.02) ease dis cardiovascular (p<0.01), disease cerebrovascular (p<0.01), mellitus diabetes (p<0.01), of migraine history past out personal of cerebrovascu history family without patients in damage field IOP Lowering could preventtreatment of the progression visual those with mean IOP less than 13 mmHg (log-rank p<0.05). test, than damage field visual of progression more significantly cally analysis. life-table Kaplan-Meier the using analyzed was stability field visual of probability The trol. normal-tension (NTG). glaucoma with patients Japanese in damage field visual of progression for factors prognostic and (IOP) pressure ocular Tokyo, Japan University, Nihon mology, lar disease (p<0.02) and cardiovascular disease (p<0.02), with (p<0.02), disease cardiovascular and (p<0.02) disease lar CONCLUSION: RESULTS: METHODS: AND SUBJECTS PURPOSE: Hayamizu. F Nakagami, T Yamazaki, Y Visual Field Damage In Patients With Normal Ten Pressure And Prognostic Factors For Progression Of The Relationship Between Lowering Intraocular abstracts sion Glaucoma Eyes with mean IOP above 13 mmHg showed statisti showed mmHg 13above IOP mean with Eyes o td te eainhp ewe lwrn intra lowering between relationship the study To O lwrn ws togy nlecd o h ex the to influenced strongly was lowering IOP

session 6: clinical perimetry II perimetry 6: clinical session Ninety-two eyes of 92 NTG patients patients NTG 92 of eyes Ninety-two Department of Ophthal of Department ------6.07.14 0 0 2 8a–9:35a : 9 – a 8 37

abstracts session 6: clinical perimetry II 2 0 0 6.07.14 10a–11:30a abstracts session 7: visual field change analysis

Estimating Sensitivity To Change From Signal-To- Change Detection Based On An Individual Patient’s Detectability Of Glaucomatous Changes Using SAP, Noise Analysis Of Test-Retest Data Variability FDT, SWAP, Flicker Perimetry, And OCT

PH Artes1 ,2, DM Hutchison1, BC Chauhan1. Dalhousie University, A Turpin1, AM McKendrick2, BC Chauhan3. RMIT University, H Nomoto1, C Matsumoto1, S Takada1, S Hashimoto1, S Canada1, Faculty of Life Sciences, University of Manchester, UK2 Melbourne, Australia1. University of Melbourne, Australia2. Dalhou- Okuyama1, Y Shimomura1, E Arimura2. Department of Ophthal- sie University, Halifax, Canada3 mology, Kinki University School of Medicine, Osaka, Japan1, Depart- PURPOSE: It is problematic to compare variability between visual ment of Ophthalmology, Sakai Hospital Kinki University School of This study uses clinical data to examine the effective- field tests that use different sensitivity scales. As an alternative, PURPOSE: Medicine, Osaka, Japan2 we propose a new methodology based on signal/noise (S/N) ra- ness of a theoretical technique we have previously published for tios to quantify how well measurements from two visual field incorporating an individual patient’s variability information into estimates of probability of change in visual fields [1]. PURPOSE: To compare the detectability of glaucomatous func- locations are distinguishable from each other. We apply this tional changes using SAP, FDT, SWAP, flicker perimetry and method to data from standard automated (SAP) and Humphrey METHODS: The clinical data set consisted of 9 primary open-an- structural changes using OCT. Matrix Frequency-Doubling perimetry (HM). gle glaucoma patients with fields measured twice a year for 5- 12 years (mean 8.3 years) with 30-2 Full Threshold (Humphrey METHODS: Fifty-five eyes of 55 patients with OAG, glaucoma sus- METHODS: Fifteen patients with open-angle glaucoma (MD, mean Field Analyzer). These patients also had frequency-of-seeing pects, and thirty eyes of 30 healthy age matched subjects were -4.0 dB; range +0.2 to -16.1 dB) were examined with SAP (24-2 (FOS) curves measured with the same stimuli using a short tested. All subjects underwent HFA 24-2 full threshold (SAP), MOCS procedure in six locations of their fields at their first SITA-Standard) and HM (24-2 ZEST). During 3 sessions, each SITA SWAP, FDT (24-2-5, 24-2-1, 30-5, 30-1), flicker perim- patient underwent 6 visual field tests with both techniques (12 visit. A cumulative Gaussian curve was fitted to each FOS, and fits with a correlation coefficient less than 90% were discarded. etry (4-zone 38S) using Octopus 311 and Stratus OCT (fast optic tests in total). S/N-ratios were established by calculating Mann- disc, fast RNFL thickness). Evaluation of the visual fields was Whitney U statistics, a non-parametric measure of separation, From the remaining FOS curves, linear regression on log-slope and threshold was used to elicit a slope-threshold relationship counting the abnormal points. The areas under the receiver op- for superior-inferior pairs of test locations. Pairwise comparisons similar to that published by Henson et al. [2]. False response erating characteristic (ROC) curves (AUC) and sensitivities at session 7: visual field change analysis between the S/N-ratios of SAP and HM were then carried out. rates were determined from the average of the asymptotes of the fixed specificities were used to assess the detectability of glau- RESULTS: Over the entire dynamic range of the instruments the FOS curves for each patient. Using this variability information coma, especially in the early stages of glaucoma and glaucoma for each patient, and specific knowledge of the Full Threshold S/N ratios of SAP and HM were similar (p>0.43, Wilcoxon). suspects. The correspondence of superior, (inferior) RNFL algorithm, we derived individual probability of change (IPoC) changes to inferior, (superior) visual hemi field was also assessed While the S/N-ratios of SAP appeared slightly larger at the high maps similar to GCP maps, and also performed a pointwise by complete, partial and no correspondence. end of the sensitivity spectrum, this finding did not reach statis- linear regression (PLR) weighted by variability information tical significance (p>0.15). (WPLR) for each patient. We compared these customised meth- RESULTS: The AUC of FDT 24-2-5, 24-2-1, 30-5, 30-1, SITA ods for determining change with standard techniques [3,4]. CONCLUSIONS: Analyses of signal-to-noise ratios provide a simple SWAP, flicker perimetry were 0.87, 0.91, 0.90, 0.97, 0.87, 0.96 and intuitive first approximation to a test’s sensitivity to change RESULTS: The IPoC maps generally agreed with GCP on the respectively in the OAG group. The AUC of average RNFL that can be compared between different psychophysical tests. classification of patients as progressing or stable, but discovered thickness and cup/disc vertical ratio were 0.96, 0.94 in the OAG Our analyses indicate that, over a large part of their dynamic progression on average 2 visits earlier than GCP. IPoC flagged group. In glaucoma suspects group, RNFL thickness had the significantly less points than GCP. WPLR, however, classified range, HM and SAP may have similar power to detect visual largest AUC (0.94) compared with cup/disc vertical ratio (0.85) all 9 patients as progressing almost immediately after their two and other functional tests (FDT 24-2-5, 24-2-1, 30-5, 30-1 (0.67, field progression. baseline measurements, which disagreed with the PLR two- 0.62, 0.69, 0.55), SITA SWAP (0.64), flicker perimetry (0.71)). omitting criteria [3] and the GCP methods. The percentage of complete and partial correspondence was CONCLUSIONS: IPoC compared favourably to GCP because both over 80% in glaucoma suspects and almost 100% in the early used the same definition of baseline (average of first two fields). stages of glaucoma with all perimeters. WPLR, however, suffered from the error characteristics of the Full Threshold algorithm used to gather the data, not allowing CONCLUSION: FDT, SWAP, flicker perimetry and OCT are useful a solid baseline estimate from the first two fields. More work procedures for discriminating between healthy eyes and the ear- is required to integrate customisation of PLR using individual’s ly stages of glaucoma. Especially, a structural change of RNFL abstracts variability data. thickness measured by OCT is useful for detecting abnormali- [1] Turpin & McKendrick. Vis Res 45, 2005. ties in glaucoma suspects. [3] Gardiner & Crabb, IOVS 43(5), 2002. 38 [2] Henson et al. IOVS 41(2), 2000. [4] Vesti et al IOVS 44(9), 2003. agreement between criteria allow confirmation of the progres the of confirmation allow criteria between agreement or examinations MD. in successive of than Reproduction results sion. in of 9.9% FD Focality pro with was observed ofof 1.3%. cases, examinations successive in reproducibility Result 1.9%. of FD and in 11.6%with ofMD<6dB with when cases 6.8% MD>6dB, in occurred criteria two between Agreement 5.7%. of FD with 17.5% of the cases whenand in MD<6dB 20.7% when MD>6dB, in criteria three the of some of progression significant observed We of indicators. MD, earlier proving often the sensitivity twice they ficity, were excluded from the study. CD and PO presented analysis. CD from obtained was (FOC) progression the of focality of index An patient. each of nations exami reordering randomly (FD) diagnoses false Weestimated (sLV). variance loss of root square the of Progression E.- (MD). defect mean of D.- Progression deviations. local progres all (GL)ofsion Global C.- the progression. on with (PO) based points score of A presence B.- (CD). curve defect cumulative the of sectors eight of progression significant on based score A A.- of were analyzed: criteria five and filtering fluctuation, reduce to threshold local performs which program, (TNT) Trend less Noise Threshold We applied 2.0). = SD 6.9; (mean aminations Spain guna, gression increased with the value of MD. the with increased gression ex 5 least at with 1.2) = (SD years 2.8 of period mean a during regression. of lineal procedures other with association in of curve, cumulative defect analysis a using sector loss field sual RESULTS: METHODS: PURPOSE: Diaz T Gonzalez-Hernandez, M Rosa, la de Gonzalez M Glaucomatous Visual Field Progression Defect Curve By Sectors And Other Criteria Of Linear Regression Analysis Of The Cumulative abstracts CONCLUSIONS: Aleman. Since sLV presented low sensitivity and GL low and speci sLV Since low sensitivity presented To to the the detect of progression capacity vi analyze Visual field of 260 glaucomatous eyes was analyzed analyzed was eyes glaucomatous 260 of field Visual Hospital Universitario de Canarias, University of La La La of University Canarias, de Universitario Hospital PO and CD indicate suspected progression earlier earlier progression suspected CD indicate and PO

session 7: visual field change analysis change field 7: visual session ------

40 years, range 40 23-57 years, under years) treatment were Vigabatrin ex analysis of the results. of the analysis quantitative and examination examiner-independent an ables en It Vigabatrin. taking patients in loss field visual the toring patient. of each field visual 90˚ were 3˚/s velocity the used to entire angular assess with constant moved I2e) and I4e (III4e, stimuli Three months). 3-13 months (range 6 was examinations between interval time mean The period. 2-years the during performed were patient each of tions examina consecutive Five 101instrument. Octopus in mented gorski used to evaluate the visual field loss during the follow-up. the during loss field visual the evaluate to used were score Gandolfo and grid Esterman modified and original Germany Tuebingen, Neuro-Ophthalmology, and amined using semi-automated kinetic perimetry (SKP) imple (SKP) perimetry kinetic semi-automated using amined Taking Vigabatrin Automated Kinetic Perimetry (SKP) In Patients Monitoring The Visual Field Changes Using Semi- CONCLUSIONS: RESULTS: METHOD: PURPOSE: Nowomiejska K taking Vigabatrin during the long-term follow-up. long-term the during Vigabatrin taking Poland Poland 1 , U Schiefer U , 1 ; University Eye Hospital, Dept. of Pathophysiology of Vision of Eye Dept. Pathophysiology Hospital, ; University Sixteen epilepsy patients (9 women, 7 men; mean age age mean men; 7 women, (9 patients epilepsy Sixteen The mean isopter area, Mean Radial Degree (MRD), (MRD), Degree Radial Mean area, isopter mean The To field the loss quantitatively in visual assess patients SKP may be a useful tool in detection and moni and detection in tool useful a be may SKP 1 , J Paetzold J , 2 . 1st Eye Hospital, Medical University, Lublin, Lublin, University, Medical Hospital, Eye 1st 2 , R Rejdak R , 1 , T Zarnowski T , 2 1 , Z Za Z , ------Fixed-Spaced Inter-Test Intervals Inter-Test Intervals Are More Efficient Than poning the next test in the case of an apparently stable field field stable apparently an the next and in test accelerating the of progres case a of suspected case the in test next the poning progression II earlier than strategy for The conditions. all numrealistic detected total III and I Strategies fields. stable of case the in progression definite of rate incidence lower a i.e., I, egy unchanged, apparently are or fal confirmation fields is suspected, progression as soon as whereas the as long as year per one to test set is testing of frequency the III, strategy In year. per tests two of frequency a at intervals per is fixed-spaced with testing formed II, strategy In year. per tests four of frequency a at intervals inter-test fixed-spaced with field performed visual is I, testing strategy In cohort. theoretical a in experiments simulation of means by compared were intervals, inter-test tive sion. situations. all in III of strategy case the lowest in ber of to in field tests be a visual performed four-year was period level. apredefined than worse be to had follow-up fields consecutive three i.e., required, were progression suspected a of confirmations two progression, using definite For fields criteria. various baseline two to compared were fields Follow-up in a time decrease at linear rates (including various no decrease). around fluctuations random distributed normally with numbers series of field visual test results was represented as a sequence of a and number, real single a as summarized was result test field visual single A span. time short a within performed is sification w wt fxdsae itrts itras n oe ih adap with one and intervals inter-test fixed-spaced with two field tests for progression detection in glaucoma. in detection for progression tests field CONCLUSIONS: RESULTS: METHODS: PURPOSE: Netherlands The Jansonius. NM Studied With Event-Detection Algorithms Perimetric Progression Detection In Glaucoma Applied To Linear Deterioration: Adaptive Strategies II and III had a higher specificity than strat than specificity higher a had III and II Strategies To determine the optimal spacing in time of visual visual of time in spacing optimal the determine To Three perimetric strategies for progression detection, detection, progression for strategies perimetric Three Perimetry in glaucoma can be optimized by post by optimized be can glaucoma in Perimetry University Medical Center Groningen, Groningen, Groningen, Groningen, Center Medical University 6.07.14 0 0 2 1 1:3 a 30 –11: a 10

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abstracts session 7: visual field change analysis 2 0 0 6.07.14 10a–11:30a abstracts session 7: visual field change analysis

Does The Enlargement Of Retinal Nerve Fiber Influence Of Ageing On Visual Field Defects Due Layer Defects Relate To Disc Hemorrhage Oc- To Stable Lesions curences Or Visual Field Loss Progression In Nor- mal-Tension Glaucoma? T Rudolph, L Frisén. Institute of Neuroscience and Physiology, Guteborg University, Sweden K Nitta1, Y Mawatari1, Y Saito1, S Ohkubo2, K Sugiyama2. Fu- kui-ken Saiseikai Hospital, Fukui, Japan1, Kanazawa University PURPOSE: To examine the effect of ageing on visual field defects due to stable lesions. Graduate School of Medical Science, Kanazawa, Japan2 METHODS: We followed 28 patients with light to moderate visual PURPOSE: To investigate the difference in clinical characteristics field defects remaining after surgery for pituitary tumors. None [disc hemorrhage (DH), visual field loss progression, and other had tumor recurrence or complicating disorders. Hence, all had clinical factors] between the cases of enlargement or non-en- stable lesions of the chiasm. Follow-up periods ranged over 4 largement of retinal nerve fiber layer defect (RNFLD) during – 18 years (median 9). Using high-pass resolution perimetry, the follow-up. we analysed results from the center-most test locations in the upper temporal and upper nasal quadrants. The former bear METHODS: We retrospectively reviewed the charts of 97 eyes of 79 the brunt of damage whereas the latter are least affected. Each patients with normal-tension glaucoma (NTG) (mean follow-up, patient contributed results from one eye only. Fixation stability 6.2 years). We examined the RNFLD using fundus photographs and reproducibility were uniformly good. Measuring values (including black-white photographs), divided into two groups; were expressed in minutes of arc. one is the enlarged RNFLD cases (enlarged group) and the oth- er is the non-enlarged RNFLD cases (non-enlarged group), and RESULTS: Measuring values from the nasal quadrants remained session 7: visual field change analysis compared the incidence of DH, visual field loss progression, and essentially constant throughout the follow-up periods, for all other clinical factors. The data were analyzed using the Kaplan- age groups. Results from the temporal (T) quadrants were con- Meier life table method to calculate the cumulative probabilities trasted with those from the nasal (N) quadrants by calculating of a stable visual field defined by two different criteria: one by the T/N ratios, which were then individually regressed over fol- mean deviation (MD, MD deterioration>3dB), and the other by low-up periods. Hence, each patient was his or her own control. glaucoma change probability analysis (pointwise definition). Most regression coefficients (25 out of 28) did not significantly differ from 0. RESULTS: We detected the enlargement of RNFLD in 41 of 97 (42.3%) in NTG eyes. The incidence of the DH was signifi- CONCLUSIONS: The rate of age-related loss of neural channels ap- cantly higher in the enlarged group (70.7%) than the non-en- pears to be identical in normal and abnormal visual field areas larged group (7.1%) (P<0.001). In the enlarged group, mean in subjects with stable mid-chiasmal lesions. baseline IOP and mean IOP during follow-up were significantly lower, the variation of MD and CPSD were significantly worse as compared to the non-enlarged group. The cumulative prob- ability of progression of visual field loss was significantly greater in patients with the enlarged group than in patients with the non-enlarged group by either criterion for progression (P<.0045, logrank test). CONCLUSIONS: The enlargement of RNFLD seems to be closely

abstracts associated with disc hemorrhage occurrence and the progression of visual field loss.

4 0 size III and 1.65 dB ± 0.02 for size V. The difference in vari in difference The V. size for 0.02 ± dB 1.65 and III for size .04 ± dB 2.55 was locations test across retest on difference V size and were different for the (p two tests < 0.001). The mean having higher variability (Figure). variability higher having III size with p<.001), was significant: (interaction ing sensitivity decreas with markedly increased then It decrease. of unit log first the about for small was V size and III size between ability IA City, Iowa Iowa, of University ogy, optl Iw Ct, IA City, Iowa Hospital, ity then rises substantially for size III stimuli compared to size V. location. at each differences) (dB dependent(dB) and as retest variability sensitivity variables the with performed were ANOVAs repeated Two-factor, sizes. within and variability retest their the sizes between point-wise sensitivities and scores, mean the compared We analyses. from excludedwere retest the or test first the either on obtained was threshold dB 0 where Test were locations weeks. 1-4 within patients retested The stimuli. III and size using stimuli standard V SITA with size using algorithm threshold full Humphrey stimuli. III size Vand size using patients glaucoma in etry Glaucoma Patients rimetry Of Size V Compared To Size III Stimuli In RESULTS: METHODS: PURPOSE: Wall M Retest Variability Of Conventional Automated Pe abstracts CONCLUSION: CONCLUSION: Charleston, IL Charleston, for the two tests for about the log first unit of sensitivity. Variabil 1,2 h sniiiis ee n vrg 33 d hge for higher dB 3.30 average on were sensitivities The To compare the retest variability of Humphrey perim To variability retest the compare We tested one eye of 120 glaucoma patients with the the with patients glaucoma 120 of eye one tested We , CF Brito CF , The retest variability in glaucomapatientsretestinThe variabilitysimilar is 3

3 , KR Woodward KR , session 8: comparison of perimetric tests perimetric of 8: comparison session 2 ; Psychology, Eastern Illinois University, University, Illinois Eastern Psychology, ; 2 , CK Doyle CK , 1 ; Veterans Administration Administration Veterans ; 2 . Ophthalmol ------Long-term fluctuation (LF), calculated as SD of threshold val threshold of SD as calculated (LF), fluctuation Long-term and in (1.0higher than SAP FDT in Pulsar (0.4 dB). src, p<0.05) induces greater learning effect. learning greater induces italthough is a possibly more forcomplex task the patient which Pulsar’s that suggests sensitivity, to FDT favours greater respect with stability greater data previous including LF. analysis maximum ROC with coincided effect learning reduced FDT: with occurred is opposite The systems. two other the than stability greater overall its effect, learning greater to due time over Technology etry, Pulsar Perimetry And Frequency-Doubling and 11.6%and respectively. 10.6% FDT and 22.1%, and 14.4% Pulsar 5.7%, 7.7%and SAP of: sLV-PSD and MD showed sensitivity 95.6%, of specificity a for analysis, ROC 11.1%,17.8%.were 7.9% and controls in ages percent same FDT. The in 31.8% and Pulsar SAP, 19.6%in in 14.9% was src) or (dB units >3 MD with cases of number the G, In 0.7). SD (1.9 src, Pulsar in 1.1) and SD dB, (2.3 SAP in than (3.1FDT 1.4,SD in p<0.0001) dB, higher significantly was ues, G. of group examination first the with compared of 90 eyes Examination experience. from controls was 90 normal SAP previous had subjects All N30). (FDT Technology bling Frequency-Dou C.- and (T30W) perimetry Modulation poral Tem Pulsar B.- (SAP). Perimetry 311 Automatic Standard Octopus TOP A.- using: months 18 during times 5 examined were sion G, (group MD mean and glaucoma early SD 1.08dB, 2.0dB) Spain Laguna, La de Universidad narias, techniques. Long-Term Fluctuation, Learning Effect, Sensitiv CONCLUSIONS: RESULTS: METHODS: PURPOSE: Gonzalez-Hernandez M Universidad Complutense de Madrid, Spain Madrid, de Complutense Universidad ity And Specificity Of Standard Automatic Perim de la Vega la de Learning effect was minimal in the 3 techniques, but techniques, 3 the in minimal was effect Learning Analyze the stability and accuracy of three perimetric perimetric three of accuracy and stability the Analyze 0 sal ee (5 ujcs wt oua hyperten ocular with subjects) (65 eyes stable 104 1 , A Hernandez-Vidal A , Although Pulsar presents slightly higher changes changes higher slightly presents Pulsar Although 1 , M Gonzalez de la Rosa de la Gonzalez M , 2 . Hospital Universitario de Ca de Universitario Hospital 1 2 , Instituto Castroviejo, Castroviejo, Instituto , 1 , R Rodriguez Rodriguez R , ------the best parameter of each test, significant differences were ob differences significant test, of each parameter best the For (AUROC=0.824). 24-2 FDT for points <5% TD of number the and (AUROC=0.801) N-30 forFDT PSD (AUROC=0.678), and sensitivity at a set level of specificity. The FDT 24-2 is, is, 24-2 FDT over time. patients for following however, suited The better specificity. of level set a at sensitivity and accuracy diagnostic of terms in N-30 FDT the as well as forms per 24-2 FDT The SAP. than sensitive more were and curacy the number of Devia Total(PSD), and Pattern (TD) Deviation Deviation Standard Pattern (MD), Mean Deviation parameters: for the following calculated level levels(80%) at a set specificity sensitivity determine to used and generated were curves ROC) ma patients and 44 healthy controls was included. Optic disc ste function. of visual tests FDT 24-2 and N-30 (FDT) perimetry technology frequency-doubling perimetry, tomated 49% (SAP), 65% (FDT N-30) and 67% and 24-2). (FDT N-30) (FDT 65% (SAP), 49% was test each for parameter best the with the associated 80%, sensitivity of specificity set a At (p=0.60). 24-2 FDT and N-30 was difference FDT of parameter best AUROCs forthe the between observed significant No (p<0.001). 24-2 FDT and SAP (p=0.01) N-30 FDT and SAP for AUROC the between served 1%. and 5% than at less triggered points (PD) tion (AU characteristic operating receiver the under Areas tests. 6 were months within taken ofstereophotographs the functional The months. three within performed tests 24-2 FDT FDT and N-30 strategy, SITA and pattern 24-2 the with (SAP) rimetry normal a had automated pe standard participants All and examination. ocular pressure intraocular elevated of history no with < 22 mmHg pressure intraocular had also controls Healthy eyes. the classify to used were fields) visual not (and reophotographs CONCLUSION: RESULTS: METHODS: PURPOSE: USA Jolla, La Diego, San at California of University Sample. Weinreb, RN PA D Ng, FA L Racette, LM Zangwill, Medeiros, In The Diagnostic Innovations In Glaucoma Study FDT N-30 And FDT 24-2 Tests Of Visual Function A Comparison Of Standard Automated Perimetry, The best parameter for each test was MD for SAP SAP for MD was test each for parameter best The Hamilton Glaucoma Center, Department of Ophthalmology, of Ophthalmology, Department Center, Glaucoma Hamilton One eye of each of one-hundred-and-fourteen glauco one-hundred-and-fourteen of each eyeof One o opr te igotc cuay f tnad au standard of accuracy diagnostic the compare To Overall, both FDT tests had higher diagnostic ac diagnostic higher had tests FDT both Overall, 6.07.14 0 0 2 1 0 5p 0 : 3 – 30p 1: 41 ------

abstracts session 8: comparison of perimetric tests 2 0 0 6.07.14 1:30p–3:05p abstracts session 8: comparison of perimetric tests

Comparison Of Frequency Doubling Technology Evaluation Of The Screening Performance Of Research On The Application Of Optic Nerve Fiber Perimetry, Off- Perimetry, And On-Perimetry In The Oculus Easyfield And Frequency Doubling Map To Fundus Perimetry Eyes With Glaucoma Technology (FDT) Perimeters N Suzuki1, H Yaguchi2. NIDEK Co., Ltd., Gamagori, JP1, Chiba S Kogure1, H Iijima1, K Kashiwagi1, S Tsukahara1. Department CA Johnson1, M Fingeret2, A White2. Discoveries in Sight, Devers University, Chiba, JP2 of Ophthalmology, Faculty of Medicine, University of Yamanashi, Eye Institute, Portland, Oregon1 and Brooklyn VA Medical Center, Yamanashi, Japan1 New York2 PURPOSE: The visual field has disability and some scotomata if the optic nerve fiber has disability around the optic disc. Some PURPOSE: To compare the threshold of frequency doubling tech- PURPOSE: To evaluate the clinical performance (sensitivity, spec- paracentral scotomata or an arcuate scotoma appear in the Bjer- nology (FDT), OFF perimeter, and ON perimeter in eyes with ificity, ease of use, test duration, etc.) of the Easyfield and FDT rum area. The perfect defects of the visual field have a series of glaucoma. perimeters for detection of glaucomatous visual field loss. scotomata from the optic disc to the nasal longitude with detour- ing around the fovea centralis. The perimetry can detect many METHODS: In ordinary perimetry, the visual stimulus is luminance METHODS: Visual field testing of both instruments was performed scotomata efficiently if some perimeters show stimuli along the changes in the test target projected on to the background screen. in 68 normal control subjects (136 eyes) and 80 patients with optic nerve fiber, because the arcuate scotoma has a series of In order to assess the difference of the stimulus effects between glaucomatous visual field loss (158 eyes) at two clinical centers, scotomata along the optic nerve fiber. light-on and light-off, we developed an OFF-perimeter and ON- according to the procedures recommended by the manufactur- perimeter. The temporal aspect of the test target luminance is ers. All participants underwent a thorough eye examination, METHODS: We sketched many optic nerve fibers and created an an abrupt reduction to 3 cd/m2 followed by a gradual recovery HFA SITA Standard visual field evaluations to be included in optic nerve fiber map. We took 27 color fundus photographs (12 to the background luminance of 150 cd/m2 in our OFF-perim- the study. Glaucoma patients were required to have mild to left eyes and 15 right eyes) of 16 ophthalmologic disease patients eter. We also developed an ON-perimeter in which the test lu- moderate visual field loss (no worse than –12 dB MD for the (6 AMD, 1 macular hole and 9 retinal disease) between the ages minance is abruptly increased to 150 cd/m2 followed by gradual HFA II procedure) and normal controls were required to have a of 37 and 82 (66.1±16.1 ages), and 6 photographs (3 right and decrease to the background luminance of 3 cd/m2. Three differ- normal eye exam and HFA visual fields. Sensitivity, specificity, left eyes) of 4 normal persons between the ages of 31 and 56 (39.8±11.4 age), and used the fundus perimeter. We measured session 8: comparison of perimetric tests ent perimetry including the OFF-perimeter, ON-perimeter and test duration, and ease of use were evaluated for each instru- frequency doubling technology (FDT) were tested in eyes with ment. the distance between the fovea centralis and the center of the glaucoma and their results were compared. Both the OFF-pe- optic disc. The optic nerve fiber map could be shown on the RESULTS: Both devices were easy to use. In contrast to the FDT rimeter and the ON-perimeter have19 test target locations as in fundus photograph. device, the Easyfield required the use of a central lens correc- the FDT N-30 program. Ten glaucoma eyes of 10 patients were tion, was more difficult to maintain eye alignment, required the RESULTS: We measured the distance between the fovea centralis examined using FDT, OFF-perimeter, and ON-perimeter. use of an eye patch, and took about 25% longer for testing glau- and the center of the optic disc, and the ratio of the distance RESULTS: The mean threshold of 190 test points of 10 eyes for coma patients and 50% longer for normal controls. Both proce- and angle of view, patient 0.379±0.024 and normal 0.359±0.016. FDT, OFF perimeter, and ON perimeter were 14.4dB (range, dures took less than 1.5 minutes per eye to complete. Specificity We were able to put both the fovea centralis of the map and the 0 – 31dB), 19.6dB (range, 0 – 35dB), 24.9 dB (range, 0 – 40), for the FDT device was between 92 and 99%, and sensitivity center of the optic disc of the map on the fundus photograph respectively. The Pearson’s correlation coefficients between was between 75 and 94%, depending on which criteria were precisely. On the other hand, we developed the software to en- FDT-OFF, FDT-ON, and OFF-ON were 0.620, 0.550, and used. For the Easyfield, specificity was between 67 and 86% able simulation of the optic nerve fiber curves, if an inspector 0.413, respectively. and sensitivity was between 63 and 88%. selects certain some points on the fundus photograph. CONCLUSION: The sensitivity of frequency doubling illusion, DISCUSSION: Both devices provided reasonably good sensitivity CONCLUSIONS: We applied the optic nerve fiber map to the fundus light-off and light-on differed in glaucomatous eyes. These re- and specificity characteristics, and could be used efficiently. perimeter, and developed the simulation software. We showed sults suggest that there is some type of functional disorder in The FDT procedure required less testing time and was some- the efficacy of the software when an inspector determines cer- eyes with glaucoma. Although the clinical meaning of these what easier to use. However, both instruments appear to be tain stimuli points. tests is unknown, further investigation will show the usefulness useful procedures for glaucoma visual field screening. The re- of these tests. producibility characteristics of the two devices will also be pre- abstracts sented.

42 yellow background used for SWAP. For clinical practice, pupil status (di status pupil SWAP.forpractice, the used For clinical background yellow by induced desensitization of degree the in differences on depend testing session to another. to session testing SWAP one from caution with only altered be should undilated) or lated for SWAP. used yellow the background to adaptation in variations by effects) size pupil (via indirectly or differences directly either for mean-deviation accounted was B/Y-W/W the in variance the of 40% More than fixation. from 9o-17o about between eccentricity retinal creasing in of function a as measured difference total-deviation B/Y-W/W the of change of rate the describing factor” “eccentricity an being factor fourth the factors, significant 4 with model a by .87) = (R described were tion) fixa (~22ofrom periphery the in differences SWAP.total-deviation The and (iii) the a forfoveal data, pupil as factor, recorded psychophysical size from derived each factor, sensitivity baseline a (ii) and factor adaptation an (i) factors: significant 3 with model multilinear a by .80) = (R scribed analyses. the in included was pupil-size Visual-field field. the of portions separate for and field were made forvisual entire the Comparisons at session. a single bright yellowformeasurements All each backgrounds. subject were made and dim using psychophysically obtained adaptation and sensitivity sual aptation properties of SWS cone pathways. cone of SWS properties aptation between the 2 visual fields were compared against foveal measures ofvi foveal measures against were compared fields visual 2 the between differences sensitivity age-corrected The fields. (W/W) white-on-white SITA 24-2 Threshold Full and fields, (B/Y) blue-on-yellow SWAP 24-2 of types fields visual were measured – Fullprocedure standard Threshold Two tested. were replacement hormone using not women middle-aged RESULTS: METHODS: PURPOSE: A Eisner Population Fields: Effects Of Visual Adaptation Within A Healthy Differences Between Swap And White-On-White Visual abstracts CONCLUSIONS: University, Portland, Oregon USA Oregon Portland, University, Neurological Sciences Institute Sciences Neurological white-on-white visual-field sensitivities are related to variation in the ad the in variation to related are sensitivities visual-field white-on-white The B/Y-W/W mean-deviation difference was successfully de successfully was difference mean-deviation B/Y-W/W The 1, 2 Twenty-six healthy amenorrheic (peri- or post-menopausal) post-menopausal) or (peri- amenorrheic healthy Twenty-six To test the hypothesis that differences between SWAP and and SWAP between differences that hypothesis the test To , MD Toomey A portion of the extra variability in SWAP sensitivities may may SWAPsensitivities in variability extra of the Aportion

session 8: comparison of perimetric tests perimetric of comparison 8: session 1, 2 , LJ Incognito 1 , Casey Eye Institute Eye Casey , 1, 2 , JP O’Malley , JP 2 , Oregon Health & Science Science & Health Oregon , 1, 2 , JR Samples 2 ------. 6.07.14 0 0 2 1 0 5p 0 : 3 – 30p 1: 3 4

abstracts session 8: comparison of perimetric tests 2 0 0 6.07.14 3:30p–5:10p abstracts session 9: analysis of visual field data

Quantifying “Second-Eye” Sensitivity Loss Stabilization And Comparison Of Top And Automated Staging Of Visual Field Defects In Frequency-Doubling Perimetry Bracketing Perimetric Strategies Using A In Glaucoma Threshold Spatial Filter AJ Anderson, AM McKendrick. Department of Optometry & P Brusini1, C Tosoni1, M Zeppieri1,2,3, L Parisi1, V Bais1, M Fel- Vision Sciences, The University of Melbourne, Australia M Gonzalez de la Rosa1, M Gonzalez-Hernandez1, T Diaz Ale- letti1, I Bignucolo1. Department of Ophthalmology, Santa Maria man1, M Sanchez Mendez1. University Hospital of the Canary Is- della Misericordia Hospital, Udine, Italy1. Department of Ophthal- PURPOSE: Previous studies have shown that the second eye tested lands. University of La Laguna. Spain1 mology, University of Udine, Italy2. Discoveries in Sight, Devers Eye on the Matrix perimeter has elevated thresholds (reduced sensi- Institute, Portland, OR, USA3 tivity) relative to the first, and that this elevation is not uniform PURPOSE: To evaluate a new perimetric spatial filter that takes across the visual field. Our study investigated how this “second- into account relations of dependence between regions of the PURPOSE: To introduce a new software, based on the Glaucoma eye effect” evolves over time at various visual field locations. glaucomatous visual field. We investigated its capacity to reduce Staging System 2 (GSS 2) formulas, for automatically classifying METHOD: We measured psychophysical thresholds in 4 subjects threshold fluctuation and compared its effect on the results of both the severity and the characteristics of glaucomatous visual for 5°square, 0.5c/° sine wave gratings counterphase flickered TOP and Bracketing (BRA) strategies. field defects assessed by the Oculus Easyfield 30-2 fast thresh- old test. at 18Hz and presented in a raised cosine temporal envelope of METHODS: 51 glaucoma patients and 30 controls were examined 600ms. Stimuli appeared in one of five interleaved locations (18° using the Octopus 1-2-3 on four occasions using program 32; two MATERIAL AND METHODS: The GSS 2 uses both the MD and CPSD/ nasal, 9° nasal, central, 9° temporal & 18° temporal). Subjects with TOP and two with BRA. Each threshold was replaced by PSD (or CLV/LV) indices to classify the visual field defects into 2 adapted binocularly (background= 45cd/m ) for five minutes be- a filtered threshold, calculated as the mean of its own value and 6 stages and in 3 different types (generalized, localized, and fore performing a five minute test with one eye (the “first-eye”) the four points best correlated with it, weighted with the correla- mixed). The lines that separate the different stages and defect followed immediately by the other (the “second-eye”). We used tion coefficient (r) that relates them. types were determined mathematically. The formulas have an opaque occluder for monocular testing. Subjects repeated the been introduced in the new software of the Oculus Easyfield RESULTS: Application of the filter had minimal effect on the abso- session 9: analysis of visual field data test series 12 times, allowing us to use a version of the “method perimeter. Forty-five patients with primary open angle glau- lute mean defect (MD) but reduced the square root of loss vari- of a thousand staircases” (Mollon & Polden, 1980. Nature 286: coma (POAG) at various stages of severity were examined both ance (sLV) by 17.75% in TOP and 28.69% in BRA, increasing the 59-62) to track changes in thresholds at 10s intervals throughout with the HFA 30-2 SITA standard test and with the Oculus 30-2 similarity between their results. Filtered TOP and BRA thresh- the course of the first- and second-eye tests. These results were fast threshold test. The visual field defects were classified us- olds were more similar than those obtained in the two unfiltered compared to baseline monocular thresholds after binocular light ing a clinical method, based on the probability maps and Bebie BRA examinations. Filtering reduced the value of short fluctua- adaptation, measured over the course of 3.5 minutes using a con- curve analysis, and with the GSS 2, automatically supplied in tion by 28.8% in TOP and 45.3% in BRA and reduced sLV fluc- ventional ZEST procedure. the Easyfield output. The level of correlation between these tuation by 15.3% in TOP and 26.3% in BRA, thus harmonizing two methods was measured. RESULTS: All subjects showed a second-eye effect. On average, the two strategies for these two parameters (p>0.05). The influ- second-eye thresholds were raised by 0.3 log at the beginning ence of filtering on MD fluctuation was minimal (p>0.05). In RESULTS: The GSS 2 showed a high level of association with the of the test, reducing to 0.2 log towards the end. There was little normal subjects the number of points beyond 5 dB of normality clinical classification method (P<0.0001) both in staging the se- change in the magnitude of the second-eye effect as a function (false scotomas) reduced by 85.6% in TOP and 66.0% in BRA, verity and differentiating the characteristics of the defects. of eccentricity. We also found a significant “first-eye effect”, while in glaucoma patients it was reduced less than 5%. where thresholds increased by approximately 0.1 log as the first- CONCLUSIONS: The GSS 2 was able to correctly stage the visual eye test progressed. CONCLUSIONS: The proposed spatial filter stabilized perimetric field defect severity of the sample studied. It was also able to ac- results, acting with greater effect on BRA than on TOP, and ap- curately distinguish the defects into three groups (generalized, CONCLUSIONS: The second-eye effect is not constant, but rather proximated their results except for MD. localized, and mixed). The new Oculus Easyfield software al- decreases as a test progresses. In contrast, thresholds in the first- lows the staging to be both automatic and easier, without the eye progressively increase with time. It is likely that light adap- need of having to manually use the GSS charts. tation differences between the two eyes, due to opaque mon- ocular patching, are partly responsible for these effects. abstracts

4 4 chine Learning Classifiers In Standard Perimetry be advantageous when data-dimension reduction is needed, for ex for needed, is reduction data-dimension when advantageous be may Clustering specificity. on depended it though mathematically-derived clustering, (ICA) the over advantage and small a (G-H showed clustering GHT) structurally-derived The SVMg. the than set (e.g., HRT data). ample when data field combining results with other high-dimensional data were –unclustered included conditions and Two control statistic. Sensitivity McNemar the using controls. compared were specificity normal 95 of eyes 95 and loss field visual early with eyes GON 73 of eyes 73 containing set an data independent to applied then were MLCs Trained controls). normal 189 eyes/189 GON; with patients glaucoma eyes/156 (156 set data training a on age plus thresholds cluster using separately trained were (SVMg)] and (cMoG) Gaussian Support Vector kernel with Machines Gaussian of Mixture [constrained MLCs Two map. each within (“cluster thresholds”) cluster each within averaged were locations field 24-2 old (GHT)] compare to a mathematically-derived scheme (variational (variational ICA). scheme analysis, independent components Bayesian Sectors mathematically-derived Test a Hemifield to compare Glaucoma (GHT)] (G-H); al., et [Garway-Heath schemes by structure-derived how (2) and optimized data, clustered with be training can eyes (GON) neuropathy optic glaucomatous and healthy categorizing (1) if determine: to schemes clustering 3 on ficity cutoff and clustering method. clustering and cutoff ficity CA Jolla, La Institute, mology CONCLUSIONS: RESULTS: METHODS: PURPOSE: and M Goldbaum Boden C Assessing Visual Field Clustering Schemes Using Ma San Diego, La Jolla, CA Jolla, La Diego, San Sensitivities were higher using cMoG than SVMg regardless of speci regardless SVMg were cMoG than using higher Sensitivities (77%). unclustered/SVMg lower than ICA/ (67%) were significantly SVMg and (64%) G-H/SVMg (79%). unclustered/cMoG than higher significantly was (92%) GHT/cMoG of Sensitivity cutoff: specificity ICA/cMoG. than GHT/cMoG with higher Sensitivity significantly was SVMg. using unclustered/ type clustering than of effect lower No (77%). cMoG significantly were (63%) (62%) G-H/cMoG ICA/cMoG both and and unclustered/cMoG to equivalent was abstracts 1 and Institute for Neural Computation, University of California at at California of University Computation, Neural for Institute and

1 For 96% specificity cutoff Forspecificity 96% To compare machine learning classifiers (MLCs) trained trained (MLCs) classifiers learning machine compare To Raw thresholds from the standard Humphrey full-thresh Humphrey standard the from thresholds Raw , K Chan K , cMoG performed better with the early glaucoma data data glaucoma early the with better performed cMoG 1 . 2, 3 2,

Hamilton Glaucoma Center, Department of Ophthal Department Center, Glaucoma Hamilton 3 , PA Sample PA , session 9: analysis of visual field data field visual of analysis 9: session 2 Computational Neurobiology Laboratories, Salk Salk Laboratories, Neurobiology Computational 1 , J Hao, T-WLee Hao, J , : Sensitivity of GHT/cMoG (77%) of GHT/cMoG Sensitivity : 1 and a random map. arandom and 2, 3 2, , RN Weinreb RN , For 90% For90% - - - - - 1

of California at San Diego, La Jolla, CA Jolla, La Diego, San at California of constrained patterns consistent with changes along the nerve nerve bundle. the fiber along changes with consistent patterns constrained tions in the first test X 52 locations in the last test). last the in X52 locations test first the in tions loca abnormal possible (52 reported are pairings location 2704 of foreach p-values associated the and proportions 0.13).These The test. of from ranged 0 proportion patients progressing to 0.35 (mean = first the in locations PD abnormal to relative cation PD 52 of more or in test locations the for first a ofPro total one 2704 pairings. location in worse) or 5% < (p p-value abnormal baseline a with patients for locations 52 of each at determined was progression p-value plot PD exhibiting pro patients of The portion review. stereophoto by occasions two on confirmed 314 from GON follow-up with years) 3.0 = patients (median ries (DIGS). Study Glaucoma in tions Innova Diagnostic the from (GON) neuropathy optic pearing ap glaucomatous with persons in progression field visual tous Germany II, Tuebingen, Department full-threshold, pattern 24-2, standard automated perimetry perimetry automated se field visual a in II) standard Field Analyzer (Humphrey exams (SAP) 24-2, pattern full-threshold, eligible, last and first the from locations test in evaluated were PD progression. plot p-value of of patterns the observed ployed the to significance determine last test relative to Montethe test. first Carlo simulation was em of PD the any worsening plotin as p-value defined was gression Innovations In Glaucoma Study (DIGS) Determined By Monte Carlo Simulation: Diagnostic Spatial Characteristics Of Visual Field Progression CONCLUSIONS: RESULTS: METHODS: PURPOSE: Weinreb RN Pascual JP To determine the spatial characteristics of glaucoma of characteristics spatial the Todetermine Progression in pattern deviation (PD) plot p-values p-values plot (PD) deviation pattern in Progression Changes in PD p-values were dependent on their lo their on dependent were p-values PD in Changes 1 , U Schiefer U , 1 Visual field progression occurs in retinotopically retinotopically in occurs progression field Visual , PA Sample 2 , J Paetzold J , 1 . Hamilton Glaucoma Center, University University Center, Glaucoma Hamilton 2 2 , LM Zangwill LM , 1 , University Eye Hospital, Hospital, Eye University , 1 , I TavaresI , 1 ------, size V and were different for the two tests (p < 0.001). The sen The 0.001). < (p tests two the for different were and V size Charleston, IL Charleston, with size III having slightly higher variability (Figure). variability higher slightly having III size with p<.001), was significant: (interaction with eccentricity increased V size and III size between variability in V. difference size The for 0.37 ± dB 1.42 and III size for 0.39 ± dB 1.58 was locations test across retest on difference mean The periphery. the in dB 4.30 to fovea the at more dB 3.47 from ranged V size of sitivity location. at each (dB) sensitivity as variable dependent the with ANOVAperformed was repeated two-factor, A sizes. within variability retest their and sizes the between sensitivities point-wise and zones, concentric scores, mean the compared We later. weeks 1-4 ed IA City, Iowa Hospital, ministration SITA standard using size III stimuli. The patients were retest were patients The stimuli. III size using standard SITA Humphrey full threshold using algorithm size V stimuli and with stimuli. III size using perimetry with variability retest and size thresholds V compare to and stimuli V size with perimetry Humphrey eccentricity. with increases and results SITA standard III size with compared testing threshold full V size for less slightly is subjects normal in ability CONCLUSION: RESULTS: METHODS: PURPOSE: Doyle CK With Size III Stimulus Size V In Normal Subjects: A Comparison Repeatability Of Automated Perimetry Using f oa Iw Ct, IA City, Iowa Iowa, of h sniiiis ee n vrg 39 d hge for higher dB 3.93 average on were sensitivities The To describe the visual field of normal subjects using using subjects normal of field visual the Todescribe We tested one eye of 58 normal subjects with the the with subjects normal 58 of eye one tested We 1 , M Wall M , The retest vari 3 1,2 , CF Brito CF , 2 ; Psychology, Eastern Illinois University, University, Illinois Eastern Psychology, ; - 3 , KR Woodward KR , 6.07.14 0 0 2 1 ; Ophthalmology, University University Ophthalmology, ; Concentric Zone Analysis Zone Concentric Degrees from Fixation from Degrees 3:3p–5:10p 5 – 30p : 3 1 . Veterans Ad Veterans 5 4 - - -

abstracts session 9: analysis of visual field data 2 0 0 6.07.14 3:30p–5:10p abstracts session 9: analysis of visual field data

Why Are SITA-SWAP Sensitivities Higher Than Those Comparison Of Central Contrast Responses To From Full Threshold SWAP? Luminance Increments And Decrements In Glaucoma

SK Gardiner1, S Demirel1, B Fortune1, CA Johnson1, A Turpin2. Dis- G Sampson1, AM McKendrick1, DR Badcock2. University of Melbourne, coveries In Sight, Devers Eye Institute, Portland, USA1; RMIT University, Australia1, University of Western Australia, Perth, Australia 2 Melbourne, Australia2 PURPOSE: Previous studies have demonstrated contrast processing PURPOSE: When the commercially-available SITA algorithm for Short abnormalities in para-central regions of the visual field in glaucoma, Wavelength Automated Perimetry (SWAP) was introduced (IOVS including in subjects where white-on-white perimetry indicated no 2003, 44:1388-1394), the authors stated that mean sensitivities using functional loss in these regions. We aimed to investigate proposed dif- SITA were on average 4.3dB higher than using Full Threshold (FT) ferences between para-central response to luminance increments and in the same subjects. 1dB of this difference is because FT defines decrements (presumed to represent separate on and off pathway re- threshold as the ‘last seen stimulus’, rather than averaging the last seen sponses) in both magno-cellular (M) and parvo-cellular (P) pathways. and last unseen stimuli. However, the remaining discrepancy is unex- METHODS: Thirteen subjects with early glaucoma and fourteen (ap- plained. proximately age-matched) controls performed luminance discrimina- METHODS: Results were analyzed from 74 eyes of 37 early glaucoma sub- tion experiments using a pedestal of four squares (subtending approxi- jects tested with FT and (one year later) SITA; and from 50 normal and mately 2 degrees) on a 30 cd/m2 background. Detection thresholds glaucoma subjects tested (within one week) using FT and the SITA- were measured separately for luminance increments and decrements like ZEST algorithm (Turpin et al, Perimetry Update 2000/2001:139- using continuously presented pedestals (24, 30 and 38 cd/m2), or 147). To test whether adaptation over time produces the discrepancy, 9 pulsed (29ms) pedestals (using the same pedestal array and lumi-

session 9: analysis of visual field data subjects were tested with SITA twice after 10-minutes pre-adaptation nance series). In each case the subject was required, while fixating (simulating adaptation levels as FT concludes), and twice without. at the centre of the array, to determine the location of a briefly pre- sented (29ms) luminance increment or decrement target square, us- RESULTS: Sensitivities using SITA within the inner 10° averaged 3.8dB ing a forced-choice response method. The steady and pulsed pedestal higher than those using FT; the difference increased to 4.5dB outside paradigms are presumed to measure contrast processing within M and 20°. Sensitivities estimated by ZEST were 2.8dB greater than FT P pathways respectively [1]. within 10°, and 3.6dB greater outside 20°. Since outer locations are test- ed last by FT, it seems FT underestimates sensitivities increasingly RESULTS: The glaucoma group required significantly larger increments as the test proceeds in time. Pre-adaptation increased sensitivities by and decrements to detect the target from the pedestal luminance for 1.1dB, so cannot account for FT results being lower than SITA. both the steady [F(107, 1) = 6.35, p<0.05] and pulsed [F(107, 1) = 6.78, p<0.05] tasks. Increments and decrements revealed deficits of similar CONCLUSIONS: A large fatigue effect, decreasing sensitivities by around magnitude. 1.5dB from beginning to concluding FT, plus the 1dB ‘last seen’ effect, would explain most of the discrepancy between algorithms. However, CONCLUSIONS: Contrast processing deficits were found within the cen- even at the four locations tested first at ±9° (so having no difference tral 2 degrees of visual field in individuals with early glaucoma who in adaptation or fatigue levels), there is still 3dB difference between had normal visual acuities and para-central white on white perimetry FT and SITA. We conclude that in SWAP, FT is underestimating measures. These deficits were not selective for presumed M or P sensitivities, especially at greater eccentricities, principally because of processing and were of equivalent size for increment and decrement increasing fatigue as the test proceeds. This large fatigue effect has im- stimuli. Study of glaucomatous performance on these tasks in the mid- plications for frequency-of-seeing curves, hill-of-vision estimates, and peripheral visual field is ongoing within our laboratory. variability. However, using SITA SWAP instead cannot be completely [1] Pokorny & Smith, 1997, Vision Res. 14(9), 2477-2485. abstracts recommended as a solution until the remaining 1-2dB of difference can be satisfactorily explained.

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map downtown portland, oregon 06 symposium program at a glance

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DISCOVERIES IN SIGHT TOUR OPENING RECEPTON tuesday, july 11 july tuesday,

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SESSION 1: SESSION 2: IPS SESSION 3: SESSION 4: lunch clinical new perimetry LECTURE: optic nerve innovative

heidelberg heidelberg perimetry I techniques Lars head & nerve topics Frisén Reclaim fiber imaging the Periphery! breakfast/presentation wednesday, july 12 july wednesday, coffee/posters/exhibits coffee/posters/exhibits haag-streit presentation WOODBURN STORES (accompanying persons)

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COLUMBIA GORGE EXCURSION DINNER AND CONCERT SESSION 5: imaging to assess optic nerve head susceptibility open discussion carl zeiss meditec business meeting thursday, july 13 july thursday, pfizer presentation breakfast/presentation coffee/posters/exhibits

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CLOSING BANQUET SESSION 6: SESSION 7: SESSION 8: SESSION 9: lunch clinical visual field comparison of analysis of

welchallyn perimetry II change analysis perimetric tests visual field data friday, july 13 july friday, closing remarks allergan presentation breakfast/presentation coffee/posters/exhibits coffee/posters/exhibits CANNON BEACH TOUR (accompanying persons)

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