Comparison of white-on-white perimetry and blue-on-yellow perimetry on visual field loss in glaucoma patients

Objective: To compare the sensitivity of white-on-white perimetry (W/W) and blue-on-bellow perimetry (B/Y) on the visual field loss of (VFL) in glaucoma. Design: Cross-sectional survey. Participants: Forty-two glaucoma patients (seventy-one eyes). Methods: The Humphrey-II-750 automated perimetry was used to examine glaucoma patients with B/Y and W/W. Patients were divided into early, moderate and advanced groups according to the visual field test scoring from Advanced Glaucoma Intervention Study (AGIS). collaborative initial glaucoma treatment study (CIGTS) scores were used to determine severity of VFL. The mean deviation (MD), pattern standard deviation (PSD) and CIGTS scores were calculated and analyzed statistically by t-test. Main Outcome Measures: Mean deviation, Pattern Standard Deviation, CIGTS scores. Results: MD was significantly lower in B/Y(-8.65±3.89 dB; -14.94±3.22 dB, respectively) than in W/W (-3.29±2.40 dB; -10.04±2.73 dB, respectively) in early and moderate groups (t=-9.21, P<0.001; t=-4.89, P<0.001, respectively). However, it was significantly higher in B/Y(-22.07±2.64 dB) than W/W(-25.20±5.48 dB) in advanced group(t= 3.93, P<0.001). PSD was significantly higher in B/Y (4.17 dB±1.20 dB) than in W/W (3.22±2.90 dB) in early group (t=2.12, P<0.05). However, it was significantly lower in B/Y (5.19±2.43 dB; 5.56±3.09 dB, respectively) than in W/W (7.98±3.20 dB; 8.19±3.37 dB, respectively) in moderate and advanced groups (t=-3.04, P<0.01; t=-2.96, P<0.001, respectively). CIGTS scoring system was significantly higher in B/Y than in W/W in early group (t=2.67, P<0.05). However, it was significantly lower in B/Y than in W/W in moderate and advanced groups (t=-4.31, P<0.05; t=-4.02, P<0.001, respectively). Conclusions: B/Y perimetry is more sensitive than W/W perimetry in detecting early glaucoma. W/W perimetry is more sensitive than B/Y perimetry in detecting moderate and advanced glaucoma. This indicates that B/Y perimetry should be applied in early glaucoma detection, while W/W would be better in monitoring the progress of moderate and advanced glaucoma.