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Presentation type	Oral presentation
Title	New perimetric strategy for advanced glaucoma .

Purpose	For evaluation of advanced glaucoma, perimetry helps to decide whether the condition is stable or deteriorates. However it is known that in advanced but stable glaucoma patients, there is pointwise a high variability in threshholds in succesive Visual Fields (VF ). Currently all perimeters start a new VF from “scratch”. The Optopol 900 offers the opportunity to use a previous VF as starting point. Our purpose is to compare test-time and variability, when this strategy is used instead of the normal approach with 1 starting point per quadrant .
Methods	In retrospect we examined a series of VF’s (Octopus 123) point by point comparing threshhold values, in 10 stable glaucoma patients. For every point the mean threshhold and SD were calculated. Prospectively each patient completed 8 VF’s on the Optopol 900 perimeter: 4 were done with standard strategy starting with one reference point per quadrant, another 4 with similar strategy, but starting from a previous exam with known defects.
Results	The mean variability (the SD of the threshold per point), was 5,5 dB in affected points on the Octopus 123 , and 5,3 dB on the Optopol 900 with the similar strategy. Starting from a previous VF , the mean variability was 3,8 dB and the time spent per VF diminished up to 20%.
Conclusion	VF’s with advanced defects (as from glaucoma damage), show a large variability in estimated threshold values ,especially when sensitivity is decreases. Starting from a previous result , perimetry takes less time finding the threshold, and the SD in thresholds diminishes, improving the diagnostic value to determine deterioration versus stability of the VF.
Conflict of interest	No

Authors 1

Initials	H
Last name	Dierick
Department	ZAS ziekenhuis , Oogheelkunde
City	Antwerpen

Authors 2

Initials	K
Last name	Hellemans
Department	ZAS ziekenhuis , Oogheelkunde
City	Antwerpen

Authors 3

Initials	S
Last name	Hershko
Department	Private practice
City	Antwerpen