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FREQUENCY DOUBLING PERIMETRY(FDT)
Dr.Jyoti Shetty Medical Director Bangalore West Lions Superspeciality Eye Hospital
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Used for early diagnosis of functional loss in glaucoma.
Based on the principle of Frequency Doubling Illusion. Tests the My cell subset of type III M cells(Magnocellular pathway)-These comprise 3-5%of the all retinal ganglion cells. These neurons are damaged early in glaucoma.
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The target used here is a 5 degree square with alternate dark and light bands.
The target has – Spatial contrast-Adjacent light and dark areas. Temporal contrast-One area that flickers between light and dark.
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This low spatial frequency sinusoidal grating(0
This low spatial frequency sinusoidal grating(0.5 cycles /degree )undergoes high temporal frequency flicker (18Hz)-The target appears to have twice as many light and dark bands---Frequency doubling illusion.
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METHOD OF TESTING Portable instrument
Tested under normal room illumination No patching No pupillary dilatation required No spectacle correction required if refractive error ≤ ± 7D.
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Newer software modifications are available- Tests Points Tested
Matrix Perimetry-Tests available-Screening -Full Threshold Tests Points Tested Time Taken N-30F 17+2 < 3 min 30-2 FDT 69 6-7 min 24-2 FDT 55 5 min 10-2FDT 44 4 min Macula 16
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In the 10-2 and macular programmes,target used is a 2° x 2° square with a spatial frequency of 0.5 cycles /degree and a temporal frequency of 12 Hz-No frequency doubling ,only flicker registered.
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Statistical software analysis is also available with age matched controls
MD,PSD,GHT Reliability Indices-False Negative,False Positive,Fluctuation
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ADVANTAGES Easy to use Not affected by refractive blur,lenticular changes,room lighting Portable instrument Rapid screening test with good accuracy With SWAP as a gold standard for early detection of glaucoma,FDT has a sensitivity of 88.9% and a specificity of 96.2%.
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Disadvantages Small scotomas <5° can be missed due to large stimulus. Though good statistical analysis is available it is not a good instrument for monitoring progress ,especially in advanced glaucoma.
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THANK YOU
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