Comparative study between the SORS and Dynamic Strategy visual field testing methods on glaucomatous and healthy subjects

Purpose: To clinically validate the non-inferiority of the Sequentially Optimized Reconstruction Strategy (SORS) when compared to the Dynamic Strategy (DS). Methods: SORS is a novel perimetry testing strategy that evaluates a subset of test locations of a visual field (VF) test pattern and estimates the untested locations by linear approximation. When testing fewer locations, SORS has shown in computer simulations, to bring improvements in speed over conventional perimetry tests, while maintaining acquisition at high quality acquisition. To validate SORS, a prospective clinical study was conducted at the Department of Ophthalmology of Bern University Hospital, over 12 months. 83 subjects (32 healthy and 51 glaucoma patients with early to moderate visual field loss) out of 114 participants were included in the study. The subjects underwent perimetry tests on an Octopus 900 (Haag-Streit, Koeniz, Switzerland) using the G pattern with both DS and SORS. The acquired sensitivity thresholds (ST) by both tests were analyzed and compared. Results: DS-acquired VFs were used as a reference. High correlations between individual STs (r > 0.74) as well as between mean defect values (r>0.88) given by DS and SORS were obtained. The mean absolute error of SORS was under 3 dB with a 7o% reduction in acquisition time. SORS overestimated healthy VFs while slightly underestimating glaucomatous VFs. Qualitatively, SORS acquisition yielded VF with detectable defect patterns, albeit some isolated and small defects were occasionally missed. Conclusion: This clinical study showed that for healthy and glaucomatous patients, SORS-acquired VFs sufficiently correlated with the DS-acquired VFs with up to 70% reduction in acquisition time. Translational Relevance: This clinical study suggests that the novel perimetry strategy SORS could be used in routine clinical practice with comparable utility to the current standard DS, whereby providing a shorter and more comfortable perimetry experience