Benefit of Stimulus Size V Perimetry for Patients With a Dense Central Scotoma From Leber’s Hereditary Optic Neuropathy

Alvaro J Mejia-Vergara; Alfredo A Sadun; Alexander F Chen; Michael F Smith; Michael Wall; Rustum Karanjia

doi:10.1167/tvst.10.12.31

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Benefit of Stimulus Size V Perimetry for Patients With a Dense Central Scotoma From Leber’s Hereditary Optic Neuropathy

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Benefit of Stimulus Size V Perimetry for Patients With a Dense Central Scotoma From Leber’s Hereditary Optic Neuropathy

Alvaro J Mejia-Vergara, Alfredo A Sadun, Alexander F Chen, Michael F Smith, Michael Wall and Rustum Karanjia

Translational vision science & technology, Vol.10(12), pp.31-31

10/21/2021

DOI: 10.1167/tvst.10.12.31

PMCID: PMC8543387

PMID: 34673906

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Abstract

Purpose: Leber’s hereditary optic neuropathy (LHON) is the most common mtDNA optic neuropathy. It most frequently causes dense bilateral central scotomas that are often characterized in clinical studies by Humphrey visual field testing (HVF) using a stimulus size III. This provides numerical quantification of the visual field defect using the mean deviation. However, this size III testing strategy has limitations. We used stimulus size V to monitor these patients and evaluated intertest variability and dynamic range to determine the testing reliability and reproducibility. Results: Stimulus size V HVFs had lower inter-test variability as measured by mean defect standard deviation (Z = 169, P < 0.01). The floor effect seen with Stimulus III HVFinLHON,waslesspronouncedwithStimulusVHVF.Thecorrelationofstimulus size III and V mean defect was strong (r = 0.90, P < 0.01), and a mathematical model was constructed to calculate the Stimulus size V mean defect from the Stimulus size III results (MDstimV = 0.988 xMDStimIII + 1.35, R2 = 0.82 P < 0.01). Conclusions: Stimulus size V HVF had lower intertest variability and a better dynamic range than Stimulus size III HVF in LHON patients. This makes the stimulus V HVF a more reliable metric to follow LHON patients especially in clinical trials. The mathematical model presented can be used to generate a Stimulus V equivalent mean defect from Stimulus III HVFs. Translational Relevance: Using Stimulus V HVF in LHON patients increases its ability to detect and quantify a response to treatment, making it a useful metric for future LHON clinical trials and the clinical setting.

Details

Title: Subtitle: Benefit of Stimulus Size V Perimetry for Patients With a Dense Central Scotoma From Leber’s Hereditary Optic Neuropathy
Creators: Alvaro J Mejia-Vergara - Doheny Eye Institute
Alfredo A Sadun - University of California, Los Angeles
Alexander F Chen - Doheny Eye Institute
Michael F Smith - University of Iowa
Michael Wall - University of Iowa
Rustum Karanjia - University of California, Los Angeles
Resource Type: Journal article
Publication Details: Translational vision science & technology, Vol.10(12), pp.31-31
DOI: 10.1167/tvst.10.12.31
PMID: 34673906
PMCID: PMC8543387
NLM abbreviation: Transl Vis Sci Technol
ISSN: 2164-2591
eISSN: 2164-2591
Language: English
Date published: 10/21/2021
Academic Unit: Neurology; Ophthalmology and Visual Sciences
Record Identifier: 9984187365302771

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