Validation and reproducibility of the Heidelberg Edge Perimeter in the detection of glaucomatous visual field defects

AIM: To validate the ability of the Heidelberg Edge Perimeter(HEP) in detecting glaucomatous visual field(VF) defects compared to the Octopus Visual Field(OVF) Analyzer and to determine the test-retest repeatability of both modalities.METHODS: This prospective, cross-sectional study was conducted at Wills Eye Hospital, Philadelphia, PA. Glaucoma subjects and unaffected controls underwent VF testing using HEP standard automated perimetry(SAP) Ⅲ 30-2 Adaptive Staircase Thresholding Algorithm(ASTA) FAST protocol and OVF G-TOP white-on-white strategy. Testing order was randomized. Pearson's correlation coefficient was calculated for both mean deviation(MD) and pattern standard deviation/square root of loss of variance(PSD/s LV). Receiver operating characteristic(ROC) curves were used to determine the diagnostic abilities of both modalities. Glaucoma subjects returned for repeat testing and intraclass correlation coefficients(ICCs) were calculated to assess test-retest repeatability. RESULTS: Seventy-nine subjects with glaucoma and 36 unaffected controls were enrolled. HEP and OVF were significantly correlated for both MD(r=-0.84; P<0.01) and PSD/s LV(r=0.79; P<0.01). Areas under the ROC curves(AUCs) were also comparable between HEP and OVF for both MD(0.74 and 0.79, respectively; P=0.26) and PSD/sL V(0.74 and 0.82; P=0.08). ICC was high for both HEP (0.96 for MD, 0.95 for PSD/s LV) and OVF(0.82 and 0.88, respectively). Mean test duration(min) was significantly shorter for OVF(2.63) compared to HEP(5.15; P<0.01). CONCLUSION: HEP and OVF show strong correlation for both MD and PSD/s LV, and have similar validity for detecting glaucoma. The test-retest repeatability is high for both HEP and OVF, however the average testing duration of HEP is significantly longer than that of OVF.