# Functional Testing for Glaucoma

> **NIH NIH R01** · LEGACY EMANUEL HOSPITAL AND HEALTH CENTER · 2021 · $407,400

## Abstract

Project Summary
Glaucoma is a leading cause of blindness both in the US and worldwide. The long-term purpose of this project
is to improve functional testing in glaucoma. Assessment and follow-up of patients currently relies on automated
perimetry to provide functional testing of the visual field. However, the ability to assess progression and/or
response to treatment using perimetry is hampered by high variability, especially in areas of moderate or severe
glaucomatous damage. This proposal will build on previous work by our laboratory to reduce the variability,
increase the dynamic range, and improve the analysis and interpretation, of these test results. Our experiments
are explicitly designed so that their results and conclusions will be rapidly translatable to clinical practice. The
project will improve the accuracy, efficiency and utility of functional testing, giving immediate impact in both
research and clinical settings, and laying groundwork for the next generation of instruments and algorithms. The
first Specific Aim is to use a novel stimulus to extend the effective dynamic range of perimetry and reduce its
variability. Current clinical perimetry relies on the test subject pressing a button when they see a stimulus
consisting of a small, stationary circle of brighter light on a white background. We propose to use a new stimulus,
which we anticipate being easier to detect, allowing reliable measurements to be made in more damaged regions
of the visual field than is currently possible, and reducing variability. The second Specific Aim is to better use
data from current clinical perimetry. We anticipate being able to detect change sooner when looking for changes
in anatomically-based clusters of test locations, rather than considering every location individually or considering
all locations simultaneously. We will derive a measure of the rate of change based on this cluster analysis that
corresponds with experienced clinicians’ opinions of the severity of disease progression, which would aid in the
staging and monitoring of disease progression, and hence aid clinical decision making. The third Specific Aim is
to perform high-accuracy testing of a subset of visual field locations. The current clinical standard is to instead
perform low-accuracy testing of a wider selection of locations. We will compare the ability of these two
approaches to detect functional change, and evaluate the effect on the strengths of the cross-sectional and
longitudinal correlations with structural measures. The three aims are complementary. It is anticipated that these
aims will improve data collection, analysis and interpretation when using perimetry. Such improvements in a test
as commonly performed as perimetry will significantly impact future clinical practice.

## Key facts

- **NIH application ID:** 10227993
- **Project number:** 5R01EY020922-09
- **Recipient organization:** LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
- **Principal Investigator:** Stuart Gardiner
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $407,400
- **Award type:** 5
- **Project period:** 2011-08-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10227993

## Citation

> US National Institutes of Health, RePORTER application 10227993, Functional Testing for Glaucoma (5R01EY020922-09). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10227993. Licensed CC0.

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