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Eye movement perimetry (EMP) expresses the decline in visual field (VF) responsiveness based on the deviation in saccadic reaction times (SRTs) from their expected age-similar responses (normative database). Since ethnic dissimilarities tend to affect saccade parameters, we evaluated the effect of such a factor on SRT and its interaction with age, stimulus eccentricity, and intensity. 149 healthy adults, spread into five age groups, drawn from Indian and Dutch ethnicities underwent a customized EMP protocol integrated with a saccade task from which the SRTs to 'seen' visual stimuli were computed. The EMP test had a total of 54 coordinates (five stimulus eccentricities) tested using Goldmann size III visual stimuli presented at four stimulus intensity (SI) levels against a constant background. Considering SRT as a dependent variable, a Generalized Linear Mixed Model analysis was conducted that revealed a statistically significant (p < 0.001) influence of ethnicity and interaction between the tested factors (ethnicity × age × stimulus eccentricity × intensity). However, during the post hoc analysis, out of the 100 possible pair-wise comparisons, only 6% (minor proportion) of the estimates showed statistical significance. Hence, the ethnic-specific differences need not be accounted for while implementing EMP in a diverse set of populations instead a collective database might serve the purpose., (© 2024. The Author(s).)

In eye movement perimetry (EMP), the saccadic reaction time (SRT) to 'seen' visual stimuli are delayed in glaucoma. Evaluating SRT behaviour in hemi-field sectors could refine its clinical implication. The development phase included 60 controls retrospectively and for the test cohort in evaluation phase, another 30 healthy subjects and 30 glaucoma patients were recruited prospectively. The SRTs were used to calculate the normative limits within 5 predefined hemi-field sectors. Scores were assigned to probabilities for SRT at the level of 5%, 2.5% 1% and 0.5%. Per sector pair, a probability score limit (PSL) was calculated at each of the four levels and were compared with the scores obtained from the test cohort. The classification accuracy 'normal versus abnormal' was assessed for PSL in EMP and compared with glaucoma hemi-field test in standard automated perimetry. We found no statistically significant differences in SRTs between the mirror sectors in healthy subjects. The PSL at 2.5% had moderate classification accuracy with a specificity of 77% and sensitivity 70%. This could be suggestive of an SRT delay in the overall visual field in glaucoma.

PRéCIS:: This eye movement perimetry (EMP) study describes the development of saccadic reaction time (SRT)-based visual field plots, which could effectively display the presence, location, and extent of glaucomatous defects and support clinical decision-making., Purpose: EMP is capable of discriminating normal from glaucomatous visual field defects on the basis of average delays in SRTs. To classify the presence and extent of age-corrected visual field defects, it is required to create SRT-based probability maps., Aim: The aim of this study was to create visual field probability plots based on SRTs and to evaluate their clinical applicability by 2 glaucoma specialists., Materials and Methods: The development phase included 95 controls segregated into 5 age-bins to estimate normative limits of SRT. Next, for the testing phase, a set of 28 healthy subjects and 24 glaucoma patients were recruited who underwent standard automated perimetry (SAP) and EMP visual field testing. Fifty-two SAP and EMP plots were presented to 2 glaucoma specialists to classify them as normal or abnormal and to identify the defect location and pattern as 1 or more of 7 predefined categories., Results: The glaucoma specialists showed a sensitivity of 100% and a specificity of 93% and 96% for identifying normal versus abnormal visual field. For specialists 1 and 2, 85% and 92%, respectively, of EMP reports were assigned to the same category as SAP. The reports that did not agree with SAP were graded to a higher defect pattern. The intermethod agreement for specialists 1 and 2 was κ 0.92 and 0.96, respectively., Conclusion: SRT-based visual field probability plots provided a comprehensive summary of an individual's visual field status and showed comparable clinical applicability to that of SAP plots.

Aim: To compare the saccadic reaction time (SRT) in both the central and peripheral visual field in normal and glaucomatous eyes using eye movement perimetery (EMP)., Materials and Methods: Fifty-four normal and 25 glaucoma subjects underwent EMP and visual field testing on the Humphrey Field Analyser (HFA) 24-2 program. The EMP is based on infrared tracking of the corneal reflex. Fifty-four test locations corresponding to the locations on the 24-2 HFA program were tested. SRTs at different eccentricities and for different severities of glaucoma were compared between normal and glaucoma subjects., Results: Mean SRT was calculated for both normal and glaucoma subjects. Mann-Whitney U test showed statistically significant (P < 0.001) differences in SRT's between normal and glaucoma subjects in all zones., Conclusion: SRT was prolonged in eyes with glaucoma across different eccentricities.