Comparison of conventional and high-pass resolution perimetry in a prospective study of patients with glaucoma and healthy controls

Objective: To determine whether high-pass resolution perimetry detected gla ucomatous visual held progression earlier than conventional perimetry. Methods: In a prospective longitudinal study, we observed 113 patients with open-angle glaucoma and with early to moderate visual field damage and 119 healthy control subjects. Each subject underwent testing at 6-month interv als using conventional and high-pass resolution perimetry (program 30-2 of the Humphrey Field Analyzer [Humphrey Instruments, Inc, San Leandro, Calif] and the Ring program of the Ophthimus perimeter [Hi-Tech Vision, Goteborg, Sweden], respectively). Our predetermined criterion for progression with c onventional perimetry was the presence of at least 4 overlapping nonedge lo cations outside the fifth percentile for test-retest variability of thresho ld deviations (defined by the Glaucoma Change Probability Analysis of the S tatpac 2 program) in 2 of 3 consecutive visual fields. We employed the iden tical criterion for progression with highpass resolution perimetry using ou r own test-retest variability data. We repeated this procedure in the contr ols to measure the false-positive rate of progression. Results: Patients were observed for a median of 4.5 years and II examinatio ns with each technique. Fifty-seven patients (50.4%) did not show progressi on with either technique. Twenty-four patients (21.2%) showed progression w ith high-pass resolution perimetry alone, whereas 6 (5.3%) showed progressi on with conventional perimetry alone. Of the remaining 26 patients (23.0%) who showed progression with both techniques, 14 (54%) showed progression wi th high-pass resolution perimetry first (median, 12 months earlier), 5 (19% ), with conventional perimetry first (median, 6 months earlier); and 7 (27% ), with both techniques at the same time. Controls were observed for a medi an of 5 years and II examinations with each technique. One control (0.8%) s howed progression with high-pass resolution perimetry. Conclusions: Our results suggest that high-pass resolution perimetry detect s glaucomatous visual field progression earlier than conventional perimetry in most patients with progression.