Perimetric Calculator

The paper considers the problems of the early glaucoma diagnosis before the development of the marked glaucomatous optic neuropathy. Special attention is paid to the methods of computer perimetry, which are important in diagnosing the presence or progression of glaucoma.

Purpose. To create the computer program “perimetric calculator” that performs mutual recalculation of perimeter data of HFA and HEP without additional perimetric studies, as well as calculation of diagnostic information content of perimeter parameters with different “cut-off points” of HFA and HEP parameters.

Patients and methods. 56 patients (85 eyes), including 16 men and 40 women aged 55 to 84 years (mean age 64.9 ± 6.4 years). All patients were divided into 2 groups: group I — 23 healthy subjects (40 eyes) without any signs of glaucoma; group II — 33 patients (45 eyes) diagnosed with the initial stage of primary open-angle glaucoma.

Results and discussion. The study revealed the comparability of the standard automated perimetry (HFA) results and Heidelberg edge perimetry (HEP), determined the most informative diagnostic criterion (MD/HEP). According to the obtained results, a computer program was created, it included two modules: the first — diagnostic information content of perimeter parameters with different “cut-off points”, the second-mutual recalculation of HFA and HEP parameters.

Conclusions. This computer program allows calculating the main indices of diagnostic information content of the perimeter parameters (sensitivity and specificity) at different “cut-off points”, gives the results of calculating the values of sensitivity, specificity and accuracy for at least 150 threshold values, allows performing mutual recalculation of the parameters of the standard automated perimeter (HFA) and Heidelberg perimeter (HEP). 

1. Nesterov A.P. Glaucoma: basic problems, new opportunities. Annals of ophthalmology = Vestnik ophthalmologii. 2008;1:3–5 (In Russ.).

2. Libman E.S. Epidemiological characteristics of glaucoma. Glaucoma = Glaukoma. 2009;1:2–3 (In Russ.).

3. Glaucoma. National guidance. Ed. by E.A. Egorov. Moscow: GEOTAR-Media; 2011. 280 p. (In Russ.).

4. Gardiner S.K., Jobnson C.A., Demirel S. Factors predicting the rate of functional progression in early and suspected glaucoma. Invest. Ophthalmol Vis Sci. 2012;53(7):3598–3604. DOI: 10.1167/iovs.11-9065

5. Kurysheva N.I., Parshunina O.A., Ardzhevnishvili T.D., Irtegova E.Y., Kiseleva T.N., Lagutin M.B., Fomin A.V. New technologies in primary open-angle glaucoma diagnostics. National Journal glaucoma = Natsional’nyy zhurnal glaucoma. 2015;14(2):22–31 (In Russ.).

6. Leung C.K., Liu S., Weinreb R.N., Ye C., Yu M., Cheung C.Y., Lai G., Lam D.S. Evaluation of retinal nerve fiber layer progression in glaucoma: a prospective analysis with neuroretinal rim and visual field progression. Ophthalmology. 2011;118(8):1551–1557. DOI: 10.1016/j.ophtha.2010.12.035

7. Chechenina N.G., Shaposhnikova I.V., Frolova E.A., Lemberg O.V. Main sources of detecting glaucoma in out-patient reception hours. Russian Medical Journal. Clinical Ophthalmology = Rossijskiy medicinskiy zhurnal. Klinicheskaya oftal’mologiya. 2008;9(4):119–120 (In Russ.).

8. Serdyukova S.A., Simakova I.L. Computer perimetry in the diagnosis of primary open-angle glaucoma. Ophthalmology journal = Oftal’mologicheskie vedomosti. 2018;11(1):54–65 (In Russ.).

9. Weinreb R.N., Garway-Heath D.F., Leung C., Crowston J.G., Medeiros F.A. Progression of glaucoma. In: The 8th Consensus Report of the World Glaucoma Association. Amsterdam: Kugler Publications; 2011.

10. Hasler S., Stürmer J. First experience with the Heidelberg Edge Perimeter® on patients with ocular hypertension and preperimetric glaucoma. Klin Monbl Augenheilkd. 2012;229(4):319–322. DOI: 10.1055/s-0031-1299210

11. Mulak M., Szumny D., Sieja-Bujewska A., Kubrak M. Heidelberg edge perimeter employment in glaucoma diagnosis-preliminary report. Clin Exp Med. 2012;21(5):665–670.

12. Quaid P., Flanagan J.G. Defining the limits of flicker defined form: effect of stimulus size, eccentricity and number of random dots. Vision Research. 2005;45(8):10751084. DOI: 10.1016/j.visres.2004.10.013

13. Machekhin V.A. Heidelberg perimetry — a new psychophysical test for glaucoma. Glaucoma = Glaukoma. 2013;(2):10–15 (In Russ.).

14. Erichev V.P., Petrov S.Y., Kozlova I.V., Makarova A.S., Reshchikova V.S. Modern methods of functional diagnostics and monitoring of glaucoma. Part 1. Perimetry as a functional diagnostics method. National Journal glaucoma = Natsional’nyy zhurnal glaucoma. 2015;14(2):75–81 (In Russ.).

15. Ratra V., Ratra D., Gupta M., Vaitheeswaran K. Comparison between Humphrey Field Analyzer and Micro Perimeter 1 in normal and glaucoma subjects. Oman J Ophthalmol. 2012;5(2):97–102. DOI: 10.4103/0974-620x.99372

16. Fabrikantov O.L., Shutova S.V., Sukhorukova A.V. Comparative characteristics of the standard automated perimetry and contour perimetry methods in diagnosis the initial stage of glaucoma. Ophthalmosurgery = Oftal’mokhirurgiya. 2015;(4):24–29 (In Russ.).

17. Fletcher R., Fletcher S., Vagner E. Clinical epidemiology. Fundamentals of evidence-based medicine. Transl. from English. Moscow: MediaSfera; 1998. 352 p. (In Russ.).