Continuous visual field test supervision may not always be necessary1☆,
Section snippets
Patients and methods
Two hundred consecutive patients undergoing VF testing for glaucoma, glaucoma suspect, and neuro-ophthalmic indications were examined twice using the 30–2 full-threshold strategy on a Humphrey Field Analyzer, once with continuous technician supervision and once without such supervision. The eye to be tested (right or left), the perimeter model to be used (HFA I or HFA II), and the order of testing (supervised or unsupervised first) were randomly selected for each patient using a table of random
Results
All patients completed the test protocol, 99 on the HFA I and 101 on the HFA II. With unreliability as the criterion (manufacturer’s “XX” flag) on any of the reliability parameters, we tested for a difference between the HFA I and HFA II in the proportion of patients who benefited from supervision (Table 1). A benefit from supervision was defined as a reliable result with supervision and an unreliable result without supervision. The proportion of patients benefiting from supervision was 10.1%
Discussion
Supervision was significantly associated with increased test reliability (P = 0.04). However, if a Bonferroni or other correction for multiple statistical tests had been applied, the significance of supervision would have disappeared entirely, despite the large sample size of 200 patients. The effect size of supervision was much smaller than had been anticipated during the study design. No difference in the beneficial effect of supervision on reliability was observed between the older HFA I and
References (5)
Cited by (17)
Glaucoma Home Monitoring Using a Tablet-Based Visual Field Test (Eyecatcher): An Assessment of Accuracy and Adherence Over 6 Months
2021, American Journal of OphthalmologyCitation Excerpt :A total of 98% of tests were completed successfully (adherence), and the data from 6 home-monitoring tests were in good agreement with 4 SAP tests conducted in clinic (accuracy). This is consistent with previous observations that experienced patients can perform VF testing with minimal oversight,50 as well as with recent findings from the Age-Related Eye Disease Study 2-HOME study group, showing that home monitoring of hyperacuity is able to improve the detection of neovascular age-related macular degeneration.51 The use of home-monitoring data was shown to reduce measurement error (between-test measurement variability).
Reliability of simultaneous visual field testing
2012, OphthalmologyCitation Excerpt :No significant differences were found in any reliability or performance measure, so the authors concluded that both strategies were equally effective. Van Coevorden et al6 also examined the utility of continuous versus initial technician supervision in VF testing. In that study, 200 patients with glaucoma or neuro-ophthalmic disease had 1 eye undergo VF testing both with and without supervision, with testing order randomized.
Comparison of the ASA, MOBS, and ZEST threshold methods
2006, Vision ResearchComparison of the effect of audiovisual and verbal instructions on patient performance while performing automated Humphrey visual field testing
2023, Indian Journal of OphthalmologyRemote Video Monitoring of Simultaneous Visual Field Testing
2022, Journal of Glaucoma
- ☆
Supported in part by NIH Grant EY01730, and in part by an unrestricted award from Research to Prevent Blindness, Inc., New York, New York.
- 1
The authors have no proprietary interest in Humphrey-Zeiss, Inc.