Journal d'ophtalmologie clinique et expérimentale
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A Comparison between the Pulsed Rising Amplitude Perimetry and the Normal Staircase Strategy in Standard Automated Perimetry

Margarita G. Todorova, Anja M. Palmowski-Wolfe, Andreas Schoetzau, Josef Flammer and Matthias J. Monhart

Background and scope: Pulsed rising amplitude perimetry (pulsed RAMP) is an improved strategy for automated static perimetry, developed to save examination time without accuracy loss. The aim of this study was to identify characteristic differences between the normal strategy (NS) and the pulsed RAMP strategy in standard automated perimetry, in order to evaluate the potential of the pulsed RAMP for threshold estimation.
Methods: Visual fields from 33 glaucoma patients, 11 controls and 4 patients with other pathology were statistically analysed. A G pattern test using the pulsed RAMP and the NS were performed in randomised order. The MD (mean defect), the sLV (square root of loss variance), the test duration and the point-wise accuracy, related to a calculated reference pre- and post-study visual fields of each patient, were evaluated.
Results: The mean examination time was 8.34 min (SD 2.02) for the pulsed RAMP, compared to 13.37 min (SD 2.67) for the NS. The Bland-Altman correlation plot for the MDs showed a trend (p=0.0018) towards higher MDs in the pulsed RAMP compared to the NS. The sLV of the pulsed RAMP was on average 1.49 dB higher than the sLV of the NS. The absolute mean local deviations, evaluated with the pulsed RAMP (r=0.38), deviated more from the references than those obtained with the NS.
Conclusion: The pulsed RAMP strategy was faster than the NS, but took longer than other established fast strategies like the SITA, TOP and Dynamic. The gain in time, compared to the NS, was paired with reduced local accuracy.