Optometry and Vision Sciences - Theses

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Subject: glaucoma × Author: BALLAE GANESHRAO, SHONRAJ ×

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    Using structural information to improve perimetry test procedures
    BALLAE GANESHRAO, SHONRAJ ( 2015)
    Existing literature on perimetry suggests that current perimetric test procedures suffer from two major limitations; 1) test-retest variability and 2) sampling density. In this thesis, I aimed to improve perimetric testing by leveraging information about an individual’s retinal structure. Current perimetric test procedures are designed to be applicable for a widespread population and are not based on individual information about a given patient. Optical Coherence Tomography (OCT) provides us with some ready information about an individual’s RNFL thickness which might be useful for perimetric testing. This thesis explores ways to incorporate information gained from OCT into perimetric test procedures. In Experiment 1, an individual’s RNFL thickness information is used to bias the prior of a Bayesian perimetric test procedure. Experiment 2 studies the limitations of the relationship between Retinal Nerve Fiber Layer (RNFL) thickness, as measured by OCT data, and perimetric thresholds. In Experiment 3, an individual’s RNFL thickness information is used to customise visual field test locations. The results of this thesis suggest that an individual’s RNFL thickness information can be used to improve the accuracy, precision and test duration of perimetric testing (Experiment 1). The strength of the structure-function relationship in glaucoma can be better revealed improve by relating both measures using customised optic nerve head sectors rather than choosing fixed optic nerve head sector boundaries (Experiment 2). This thesis also shows that customising visual field locations based on the individual’s RNFL thickness improves the chances of detecting abnormal visual field locations (Experiment 3).