Spatial correlation between localized decreases in exploratory visual search performance and areas of glaucomatous visual field loss

  • Cassia Senger
  • Marcelo Jordão Lopes da Silva
  • Carlos Gustavo De Moraes
  • André Messias
  • Jayter Silva PaulaEmail author



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.


Primary 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.

Ethical approval

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

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Cassia Senger
    • 1
  • Marcelo Jordão Lopes da Silva
    • 1
  • Carlos Gustavo De Moraes
    • 2
  • André Messias
    • 1
  • Jayter Silva Paula
    • 1
    Email author
  1. 1.Department of Ophthalmology, Otorhinolaryngology and Head and Neck SurgeryRibeirão Preto Medical School- University of São PauloSão PauloBrazil
  2. 2.Department of Ophthalmology, Edward S. Harkness Eye InstituteColumbia University Medical CenterNew YorkUSA

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