Contrast sensitivity and computerized perimetry in early detection of glaucomatous change

Goldmann (kinetic) and computerized static (Humphrey 30-2, Octopus 32) visual fields were recorded on patients contemporaneously with contrast sensitivity with spatial and temporal modulation to investigate which test was most likely to detect early change. The tested population included 29 patients with ocular hypertension or early glaucoma (57 eyes). All fields and contrast sensitivity were analyzed relative to pre-established criteria. There were no differences in the proportion of normal/abnormal results comparing Humphrey, Octopus and contrast sensitivity, but significantly fewer abnormal results were obtained as a result of Goldmann testing than with the Humphrey (P <0.01) or by contrast sensitivity (P<0.001). Eyes with signs of early glaucoma seem to show spatial frequency-specific losses which are dependent on temporal frequency. Results suggest that both contrast sensitivity and computerized static threshold perimetry may be more sensitive measures of early glaucomatous damage than is standard kinetic perimetry.