Performance of 24-2C Visual Field Grid in Detecting Central Glaucomatous Defects: A Comparative Study with Microperimetry

PRECIS: Our study shows that the 24-2C VF test provides central functional information strongly correlated with 10-2 and MAIA measurements, with a shorter testing time. It may serve as a useful complementary tool in routine glaucoma assessment. PURPOSE: To compare performance of 24-2C visual field (VF) grid and microperimetry in detecting central defects in glaucoma patients, and to correlate perimetric parameters with anatomical alterations. MATERIALS AND METHODS: This cross-sectional, single-center study included 214 eyes (118 glaucoma, 96 healthy). Participants underwent VF testing using 24-2C SITA-Faster, MAcular Integrity Assessment (MAIA) microperimetry, and 10-2 SITA-Standard grids. Macular imaging, including ganglion cell-inner plexiform layer complex (GC-IPL) analysis, was performed using Cirrus OCT. The primary outcome was a comparison of global indices between 24-2C grid and microperimetry. Secondary outcomes included comparisons with 10-2 grid, structure-function correlation, test duration, and 24-2C grid performance based on glaucoma severity. RESULTS: 24-2C Mean Deviation (MD) correlated significantly (P<0.001) with MAIA average threshold (R²=0.72) and CMS (R²=0.83). Significant correlations were also observed between 24-2C and 10-2 grids for MD (R²=0.77), PSD (R²=0.65), and CMS (R²=0.87). 24-2C grid required a shorter testing time (P<0.001) than MAIA and 10-2 grids. GC-IPL analysis revealed a significant correlation with 24-2C grid (P<0.001), particularly in the superior nasal sector (r=0.631). 24-2C grid demonstrated a stronger correlation with microperimetry for CMS, with r=0.674 in early-stage glaucoma and r=0.651 in advanced-stage glaucoma. CONCLUSION: 24-2C VF grid has a potential complementary role in glaucoma assessment for detecting central VF defects in glaucoma patients. Its structure-function correlation supports its use as a promising tool in routine clinical practice.