Comparison of 24???2 and 30???2 Perimetry in Glaucomatous and Nonglaucomatous Optic Neuropathies

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Abstract
To determine whether the 24–2 Humphrey visual field (HVF) (Humphrey, San Leandro, CA) strategy provides information comparable to that provided by the 30–2 strategy in patients with optic nerve disease. In part A of the study, an occluder device was designed to cover the additional outer 22 points tested in the 30–2 strategy of 187 HVFs from neuro-ophthalmology patients with nonglaucomatous optic neuropathy and 206 HVFs from patients with glaucoma. This device converted the gray scale adn probability plots of the 30–2 HVF to 24–2 field. Fields were initially read using the occluder and then were read in a masked manner without the occluder and compared. In part B, 15 healthy volunteers performed both 30–2 and 24–2 HVFs. Testing time and global indices were compared. Ninety-five percent of the fields in the neuro-ophthalmology patients, 96% of the fields in patients under observation for suspecte dglaucoma, 98% of the fields in patients with ocular hypertension, and 100% of the fields in patients with glaucoma were read similarly with the 24–2 and 30–2 strategies. In the few cases in which a discrepancy was noted between the 24–2 and the 30–2 fields, appropriate clinical management would not have been compromised by using the 24–2 strategy. Most of these cases were in patients with idiopathic intracranial hypertension and very subtle nerve fiber bundle defects. The 24–2 strategy had a significantly lower pattern standard deviation (P In most cases, the 24–2 testing strategy provides information comparable to that provided by the 30–2 strategy in a shorter time and with less variability. A 30–2 HVF may be warranted in patients under observation for evolving idiopathic intracranial hypertension.

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