Clinical Publications

TEMPO

A new static visual field test algorithm: the Ambient Interactive ZEST (AIZE)

AUTHORS:

Nomoto H, Matsumoto C, Okuyama S, Kimura S, Inoue S, Yamanaka K, Kusaka S.

PUBLICATION:

Sci Rep. 2023 Sep 11;13(1):14945. doi: 10.1038/s41598-023-42266-z.

Study Purpose

To evaluate the performance of a new perimetric algorithm (AIZE) by computer simulation

Overview

Study Design

Simulation study

# of Eyes/
Patients

10 glaucomatous and 10 normal empirical visual field (VF) test results simulated with 5 error conditions: 3% false positives (FP), 3% false negatives (FN), 9% FP and 9% FN, 15% FP and 15% FN, 3% FP and 15% FN, 15% FP and 3% FN

Study Device

Computer simulations using: AIZE (ambient interactive zippy estimation by sequential testing)*
Non-weighted test strategy (WL = 0)
Weighted test strategy (WL = 0.33)

Outcome Measures

Total number of test presentations and root mean square error (RMSE) of estimated visual sensitivities

Results

In both glaucomatous (G) and normal (N) VFs, the fixed-weighted test had the lowest number of test presentations (median G 256, N 139), followed by the AIZE (G 285, N 174) and the non-weighted test (G 303, N 195) (Figure 1)
The RMSE of the fixed-weighted test was lower (median 1.7 dB) than that of the AIZE (1.9 dB) and the non-weighted test (1.9 dB) for normal VFs, whereas the AIZE had a lower RMSE (3.2 dB) than the fixed-weighted test (4.5 dB) and the non-weighted test (4.0 dB) for glaucomatous VFs (Figure 1)
Test-retest variability of AIZE, non-weighted test, and the fixed-weighted test at the same test location yielded median RMSE values of 2.7 dB, 3.0 dB, and 2.7 dB for glaucomatous VFs. For normal VFs, the median RMSE values were 2.0 dB, 3.0 dB, and 1.6 dB
All 3 algorithms underestimated simulated sensitivities for true sensitivities of 34 dB and higher. The non-weighted test under-estimated 28 dB and higher sensitivities whereas the weighted test showed a larger variability of simulation sensitivities in the 8-20 dB range compared to AIZE and the non-weighted test

IMOvifa reduced measurement time by

39%

FIGURE 1

The total number of test presentation with AIZE, the non-weighted and the fixed-weighted tests under 5 error conditions in normal (A) and glaucoma (B). The RMSE with AIZE, the non-weighted and the fixed-weighted tests under 5 error conditions in normal (C) and glaucoma (D). Adapted from Sci Rep. 2023 Sep 11;13(1):14945. doi:10.1038/s41598-023-42266-z.

Conclusions

Simulation results showed that AIZE had fewer test presentations and a smaller RMSE than the non-weighted test strategy. Thus, AIZE is a test algorithm that saves time without affecting the accuracy for glaucomatous visual fields.