Rapid, Non-Contact, Objective Multifocal Assessment of Visual Function in Glaucoma

We compared a rapid fifth-generation (5G) objectiveFIELD Analyser® (OFA®) test with two fourth-generation (4G) 8 min tests in the assessment of glaucoma. We assessed the relative diagnostic power of these three OFA tests, namely two high-resolution 4G tests (wide-field OFA30 and macular OFA15), and a new 5G 90 s test (wide-field OFA30-20). Glaucomatous eyes were classified into mild, moderate, and severe based upon the Matrix 24-2 perimetry Mean Defect (MD). Diagnostic power was estimated by Area Under the Curve of Receiver Operating Characteristic plots (AUROC) and standardised effect sizes (Hedge’s g) for each category of glaucoma severity. We tested 37 glaucoma patients (11 females) aged 70.5 ± 9.19 years. Their average Matrix MD was −7.71 ± 6.35 dB. Age-matched normal controls were acquired for the 4G and 5G tests. Per-region sensitivities outperformed per-region response delays. For severe eyes, the OFA30-20 produced an AUROC of 89.7 ± 3.30, which was not significantly different to the OFA30 and OFA15. Hedge’s g was ≥2.45 for all those comparisons. We examined the agreement of the MD and Pattern Standard Deviations (PSD) of the two wide-field (OFA30 and OFA30-20) tests. The significant correlations for the sensitivity and delay MDs were >0.85, and for PSDs 0.53 and 0.69. The rapid 5G OFA30-20 test was comparable to the 8 min tests. It therefore may be highly useful for younger people and infirm persons who cannot tolerate longer tests.