Random Dot Motion Stimuli Are More Sensitive than Light Stimuli for Detection of Visual Field Loss in Ocular Hypertension Patients

PURPOSE: To determine whether motion detection perimetry or luminance size threshold perimetry (a test using the motion perimetry method with luminance stimuli) is more sensitive in detecting visual loss in ocular hypertension patients. METHODS: Motion perimetry uses a customized computer graphics program to detect a subject's ability to identify a coherent shift in position of moving dots in a defined circular area against a background of fixed dots. Motion size threshold is defined as the smallest circular area within which dot motion is detected. Patients respond by touching the area of the computer monitor where they perceive the stimulus with a light pen. The localization errors are measured as the number of pixels from target center for each trial. Luminance size threshold perimetry uses the same technique except the background is dark gray and the stimuli are filled lighter gray circles. We tested one eye in each of 27 ocular hypertension patients and 27 age-matched normal subjects with both tests. Our main outcome measures were motion and luminance size thresholds, total deviation probability plot data, and spatial localization errors. RESULTS: With the total deviation probability plot analysis, the ocular hypertension patients had a greater number of abnormal test locations with motion perimetry stimuli than with luminance stimuli. The abnormal test points were located most often in the superior and inferior nasal regions. Six subjects had nerve fiber bundle-like defects to motion stimuli whereas three patients had defects with luminance size threshold perimetry. The ocular hypertension patients had significantly greater localization errors than the controls with both tests. CONCLUSIONS: Using a size thresholding technique in ocular hypertension patients, random dot motion stimuli appear to be more sensitive than luminance stimuli. Errors in stimulus localization are significantly increased in ocular hypertension patients, independent of the stimulus (motion or luminance) used.