Spatial correlation between localized decreases in exploratory visual search performance and areas of glaucomatous visual field loss
Visual search is a critical skill for several daily tasks and may be compromised in patients with impaired vision. The objective of this study was to study the relationships between exploratory visual search performance (EVSP) visual field (VF) sensitivity in patients with glaucoma.
Primary open-angle glaucoma patients (POAG; n = 29) and healthy (Control; n = 28) individuals with best corrected visual acuity better than 0.2 logMAR underwent a comprehensive ophthalmological examination, including Humphrey VF tests (24-2 SITA-Standard), and a monocular exploratory visual search digit-based task performed using a software that quantifies the time spent to find a targert on a random array of digits distributed on nine sequential screens. The screens were divided into five areas to topographically match with five VF sectors.
As expected, POAG eyes had worse VF mean deviation (MD) sensitivity and EVSP than Controls (MD − 8.02 ± 7.88 dB vs − 1.43 ± 1.50 dB, p < 0.0001; and total EVSP time 106.42 ± 59.64 s vs 52.75 ± 19.07 s, p < 0.0001). MD sensitivity of both groups significantly correlated with total EVSP time (POAG r = − 0.45, p = 0.01; and Control r = 0.37, p = 0.049). A significant relationship was observed between EVSP (individual time) and both visual acuity (p = 0.006) and glaucoma diagnosis (p = 0.005). The mean sensitivity of the peripheral VF areas of the POAG group showed significant correlation with the individual search time in the corresponding spatial areas, except in the peripheral superior temporal area (r = − 0.35, p = 0.06).
These data indicate that POAG patients’ EVSP is impaired in topographically-correspondent VF areas with sensitivity loss. Visual search may be considered as a measure of impairment of daily activities in glaucoma patients, if further similar tests using binocular conditions corroborate our findings.
KeywordsPrimary open-angle glaucoma Visual search Visual field defects Visual impairment
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. We obtained the approval from the local Ethics Committee of the School of Medicine of Ribeirão Preto – University of São Paulo (Protocol no. 660.663-2015).
Informed consent was obtained from all individual participants included in the study.
- 2.Graham SL, Drance SM, Chauhan BC et al (1996) Comparison of psychophysical and electrophysiological testing in early glaucoma. Invest Ophthalmol Vis Sci 37:2651–2662Google Scholar
- 6.Chen YF, Wang TH, Hung PT (1997) Automated perimetry in primary open-angle glaucoma. J Formos Med Assoc 96:441–445Google Scholar
- 15.Kandel ER, Schwartz TM, Siegelbaum SA, Hudspeth AJ (2014) [Princípios de Neurociências - Livros na Amazon Brasil], 5th ed. AMGH Editora Ltda (editor). Porto Alegre, BrazilGoogle Scholar
- 28.Bickler-Bluth M, Trick GL, Kolker AE, Cooper DG (1989) Assessing the utility of reliability indices for automated visual fields. Testing Ocular Hypertensives Ophthalmology 96:616–619Google Scholar
- 42.Whittaker SG, Budd J, Cummings RW (1988) Eccentric fixation with macular scotoma. Invest Ophthalmol Vis Sci 29:268–278Google Scholar