Evaluation of the Perimouse Online Suprathreshold Visual Field Test for Glaucoma Screening in a Chinese Population: A Comparison with the Humphrey Field Analyzer
- Journal
- Clinical ophthalmology (Auckland, N.Z.) (Q1)
- Published
- 24 October 2026
- Study design
- Case-control study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Xiaoyuan Shen, Zidong Chen, Kaixin Tan, Yanmei Fan, Pingping Liu, Haorui Wang, et al.
- PMID
- 42953797
- DOI
- 10.2147/OPTH.S649252
Why clinicians should know about it
- Picked for Ophthalmology (paper of the day, 3 November 2026): Diagnostic accuracy of rapid visual-field screening for glaucoma
Abstract
PURPOSE: To evaluate the diagnostic performance and spatial agreement of an online suprathreshold perimeter (Perimouse) compared with the Humphrey Field Analyzer (HFA) for detecting glaucomatous visual field defects. PATIENTS AND METHODS: In this prospective comparative study, 174 participants (283 eyes with open-angle glaucoma or healthy controls) underwent Perimouse suprathreshold program and HFA. Abnormal points (missed stimuli in Perimouse; points with P<0.5% on HFA total deviation map) were compared. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Point-wise performance used neural network-derived area under the curve (AUC) and Cohen's κ. RESULTS: Perimouse abnormal-point counts were correlated with HFA abnormal-point counts (r = 0.88, P < 0.001) and negatively correlated with HFA mean deviation (r = -0.80, P < 0.001). The intraclass correlation coefficient for abnormal-point counts between Perimouse and HFA was 0.93, and Bland-Altman analysis showed a mean bias of 0.73 abnormal points, with 95% limits of agreement ranging from -10.70 to 12.17. A cutoff of five abnormal points achieved 85.9% sensitivity and 97.9% specificity (AUC = 0.97), with performance improving with disease severity. Point-wise κ values ranged from 0.32 to 0.78 (AUC, 0.67-0.96). The test duration for Perimouse was 2.64 ± 1.83 minutes. CONCLUSION: Perimouse demonstrated reasonable overall diagnostic accuracy for detecting HFA-defined visual field defects. Diagnostic performance was higher for moderate and advanced glaucomatous defects than for early defects, with variable point-wise agreement with HFA. Perimouse may serve as a rapid, adjunctive tool for preliminary functional screening of glaucomatous visual field loss.
Abstract as published, via PubMed.
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