Optometry and Vision Sciences - Theses
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ItemIncreased spatial sampling in automated static visual field testing( 2022)The overarching aim of this thesis was to explore various approaches to increase spatial sampling in clinical static automated perimetry (SAP) testing. The motivation for this aim arose from observations that clinically implemented SAP methods use a “one-test-fits-all” fixed test pattern, despite the fact that patterns of visual field loss vary markedly between individuals. This thesis explored whether it is possible to increase spatial sampling without increasing test duration, and the pros and cons of such as approach. To approach this problem, this thesis engaged a range of methods, including direct experimental work with patients, survey research with healthcare consumers, and explored the opinions of expert clinicians. The Australian Reduced Range Extended Spatial Test (ARREST) is a new perimetric approach that has been shown to increase spatial sampling individually without increasing the test time. ARREST has previously been developed and evaluated using computer simulations. The first experiment in this thesis (Chapter 3) evaluated the feasibility and performance of the ARREST approach in testing people with established visual field loss. Chapter 4 in this thesis investigated patients’ subjective experience with current SAP testing using a mixed-method survey and asked their preferences and priorities for future perimetric developments. The final experiment in this thesis (Chapter 5) explored potential alternative methods for a glaucoma-specific ARREST approach by utilising clinically available information such as clinicians’ views and data from OCT imaging. Taken together, the results of these experiments demonstrate that increasing spatial sampling without increasing test duration is feasible with the ARREST approach. Furthermore, patients report that they would prefer tests that produce more information about their vision. In order to gain more information about their vision, patients also report being willing to perform more visual field tests and increase the frequency of visits for testing. The ARREST approach is currently agnostic to disease-specific needs hence this thesis also explored other clinically available information that might potentially be useful for stimulus placement for a glaucoma-specific ARREST approach. The results from the final experiment demonstrate that clinical experts vary significantly in their choice of stimulus locations to prioritise for further testing, but tend to favour placement in areas important for quality of life. Overall, this thesis provides possible methods for increasing spatial sampling without increasing test duration and demonstrates the importance of considering user and consumer input in the design of perimetric procedures.