International Ophthalmology

, Volume 28, Issue 5, pp 347–353 | Cite as

The association of office intraocular pressure fluctuation in ocular hypertension with frequency doubling technology perimetry abnormality

Original Paper


Purpose To characterize intraocular pressure (IOP) and central corneal thickness (CCT) measurements of ocular hypertension (OHT) patients with and without frequency doubling technology (FDT) perimetry test abnormalities. Patients and methods In this prospective, observational, cross-sectional, comparative case series, one eye of 33 OHT patients was randomly chosen. All OHT patients had IOP ≥23 mmHg in 2 out of 3 measurements on the test day, normal appearing discs and nerve fiber layer, and normal white on white standard automated perimetry (SAP). Several IOP calculations (outpatient IOP, highest office IOP, mean office IOP, office IOP fluctuation, and office IOP peak), CCT, SAP and FDT parameters were compared between OHT patients with repeatable FDT perimetry abnormality and normal FDT perimetry. Results Eight (24%) of 33 OHT patients had an abnormal FDT perimetry test. The median office IOP fluctuation (5.0 vs 2.0, P = 0.007), office IOP peak (3.2 vs 1.0, P = 0.004), and FDT pattern standard deviation (PSD) (5.03 v 3.32, P = 0.000) were significantly higher in OHT patients with repeatable FDT perimetry test abnormalities compared to OHT patients with normal FDT perimetry test. Office IOP fluctuation and office IOP peak were significantly correlated with both number of significantly depressed FDT points and FDT PSD index. CCT measurements and SAP global indices did not differ significantly in OHT patients with and without FDT perimetry test abnormality. Conclusion Our results suggest that currently diagnosed OHT patients who have large office IOP fluctuations and office IOP peaks are more likely to have repeatable FDT perimetry test abnormalities. These results suggest that OHT patients with large IOP fluctuations and IOP peaks are more likely to have early glaucomatous damage, and this should be taken into account when assessing the risk of conversion to primary open angle glaucoma.


Ocular hypertension Intraocular pressure Fluctuation Central corneal thickness Frequency doubling Standard automated perimetry 


  1. 1.
    Gordon MO, Beiser JA, Brandt JD, et al (2002) The ocular hypertension treatment study. Baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol 120:714–720; discussion 829–830PubMedGoogle Scholar
  2. 2.
    Asrani S, Zeimer R, Wilensky J et al (2000) Large diurnal fluctuations in intraocular pressure are an independent risk factor in patients with glaucoma. J Glaucoma 9:134–142PubMedGoogle Scholar
  3. 3.
    Kerrigan-Baumrind LA, Quigley HA, Pease ME et al (2000) Number of ganglion cells in glaucoma eyes compared with threshold visual field tests in the same persons. Invest Ophthalmol Vis Sci 41:741–748PubMedGoogle Scholar
  4. 4.
    Maddess T, Henry GH (1992) Performance of nonlinear visual units in ocular hypertension and glaucoma. Clin Vis Sci 7:371–383Google Scholar
  5. 5.
    Anderson AA, Johnson CA (2002) Mechanisms isolated by frequency-doubling technology perimetry. Invest Ophthalmol Vis Sci 43:398–401PubMedGoogle Scholar
  6. 6.
    Cello KE, Nelson-Quigg JM, Johnson CA (2000) Frequency doubling technology perimetry for detection of glaucomatous visual field loss. Am J Ophthalmol 129:314–322PubMedCrossRefGoogle Scholar
  7. 7.
    Iwasaki A, Sugita M (2002) Performance of glaucoma mass screening with only a visual field test using frequency doubling technology perimetry. Am J Ophthalmol 134:529–537PubMedCrossRefGoogle Scholar
  8. 8.
    Soliman MAE, Jong LAMS, Ismaeil AA et al (2002) Standard achromatic perimetry, short wavelength automated perimetry, and frequency doubling technology for detection of glaucoma damage. Ophthalmology 109:444–454PubMedCrossRefGoogle Scholar
  9. 9.
    Dayanır V, Sakarya R, Özcura F et al (2004) Effect of corneal drying on central corneal thickness. J Glaucoma 13:6–8PubMedCrossRefGoogle Scholar
  10. 10.
    Johnson CA, Sample PA, Cioffi GA et al (2002) Structure and function evaluation (SAFE): I. criteria for glaucomatous visual field loss using standard automated perimetry (SAP) and short wavelength automated perimetry (SWAP). Am J Ophthalmol 134:177–185PubMedCrossRefGoogle Scholar
  11. 11.
    Medeiros FA, Sample PA, Weinreb RN et al (2003) Corneal thickness measurements and FDT perimetry abnormalities in ocular hypertensive eyes. Ophthalmology 110:1903–1908PubMedCrossRefGoogle Scholar
  12. 12.
    Jonas JB, Holbach L (2005) Central corneal thickness and thickness of the lamina cribrosa in human eyes. Invest Ophthalmol Vis Sci 46(4):1275–1279PubMedCrossRefGoogle Scholar
  13. 13.
    Jonas JB, Stroux A, Welten I et al (2005) Central corneal thickness corraleted with glaucoma damage and rate of progression. Invest Ophthalmol Vis Sci 46(4):1269–1274PubMedCrossRefGoogle Scholar
  14. 14.
    Medeiros FA, Sample PA, Weinreb RN et al (2004) Frequency doubling technology perimetry abnormalities as predictors of glaucomatous visual field loss. Am J Ophthalmol 137:863–871PubMedCrossRefGoogle Scholar
  15. 15.
    Leske MC, Heijl A, Hussein M et al (2003) Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 121:48–56PubMedGoogle Scholar
  16. 16.
    Cello KE, Nelson-Quigg JM, Johnson CA (2000) Frequency Doubling Technology perimetry for detection of glaucomatous visual field loss. Am J Ophthalmol 129:314–322PubMedCrossRefGoogle Scholar
  17. 17.
    BurnsteinY, Ellish NJ, Magbalon M et al (2000) Comparison of frequency doubling perimetry with Humphrey visual field analysis in a glaucoma practice. Am J Ophthalmol 129:328–333PubMedCrossRefGoogle Scholar
  18. 18.
    Patel SC, Friedman DS, Varadkar P et al (2000) Algorithm for interpreting the results of frequency doubling perimetry. Am J Ophthalmol 129:323–327PubMedCrossRefGoogle Scholar
  19. 19.
    Trible JR, Schultz RO, Robinson JC et al (2000) Accuracy of glaucoma detection with frequency-doubling perimetry. Am J Ophthalmol 129:740–745PubMedCrossRefGoogle Scholar
  20. 20.
    Wadood AC, Azuara-Blanco A, Aspinall P et al (2002) Sensitivity and specificity of frequency-doubling technology, tendency-oriented perimetry, and Humphrey Swedish interactive threshold algorithm-fast perimetry in a glaucoma practice. Am J Ophthalmol 133:327–332PubMedCrossRefGoogle Scholar
  21. 21.
    Stoutenbeek R, Heeg GP, Jansonius NM (2004) Frequency doubling perimetry screening mode compared to the full-threshold mode. Ophthal Physiol Opt 24:493–497CrossRefGoogle Scholar
  22. 22.
    Landers JA, Goldberg I, Graham SL (2003) Detection of early visual field loss in glaucoma using frequency-doubling perimetry and short-wavelength automated perimetry. Arch Ophthalmol 121:1705–1710PubMedCrossRefGoogle Scholar
  23. 23.
    Chauhan BC, Johnson CA (1999) Test-retest variability of frequency-doubling perimetry and conventional perimetry in glaucoma patients and normal subjects. Invest Ophthalmol Vis Sci 40:648–656PubMedGoogle Scholar
  24. 24.
    Heeg GP, Ponsioen TL, Jansonius NM (2003) Learning effect, normal range, and test-retest variability of frequency doubling perimetry as a function of age, perimetric experience, and the presence or absence of glaucoma. Ophthal Physiol Opt 23:535–540CrossRefGoogle Scholar
  25. 25.
    Horn FK, Wakili N, Junemann AM et al (2002) Testing for glaucoma with Frequency-Doubling perimetry in normals, ocular hypertensives, and glaucoma patients. Graefes Arch Clin Exp Ophthalmol 240:658–665PubMedCrossRefGoogle Scholar
  26. 26.
    Sample PA, Bosworth CF, Blumenthal EZ et al (2000) Visual function-specific perimetry for indirect comparison of different ganglion cell populations in glaucoma. Invest Ophthalmol Vis Sci 41:1783–1790PubMedGoogle Scholar
  27. 27.
    Landers J, Goldberg I, Graham S (2000) A comparison of short wavelength automated perimetry with frequency doubling perimetry for the early detection of visual field loss in ocular hypertension. Clin Experiment Ophthalmol 28:248–252PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  1. 1.Department of OphthalmologyAdnan Menderes UniversityAydinTurkey
  2. 2.Department of Public HealthAdnan Menderes UniversityAydinTurkey

Personalised recommendations