The Association Between Visual Field Reliability Indices and Cognitive Impairment in Glaucoma Patients

Abstract Background Perimetry is important in the management of children with glaucoma, but there is limited evidence-based guidance on its use. We report an expert consensus-based study to update guidance and identify areas requiring further research. Methods Experts were invited to participate in a modified Delphi consensus process. Panel selection was based on clinical experience of managing children with glaucoma and UK-based training to minimise diversity of view due to healthcare setting. Questionnaires were delivered electronically, and analysed to establish ‘agreement’. Divergence of opinions was investigated and resolved where possible through further iterations. Results 7/9 experts invited agreed to participate. Consensus (≥5/7 (71%) in agreement) was achieved for 21/26 (80.8%) items in 2 rounds, generating recommendations to start perimetry from approximately 7 years of age (IQR: 6.75–7.25), and use qualitative methods in conjunction with automated reliability indices to assess test quality. There was a lack of agreement about defining progressive visual field (VF) loss and methods for implementing perimetry longitudinally. Panel members highlighted the importance of informing decisions based upon individual circumstances—from gauging maturity/capability when selecting tests and interpreting outcomes, to accounting for specific clinical features (e.g. poor IOP control and/or suspected progressive VF loss) when making decisions about frequency of testing. Conclusions There is commonality of expert views in relation to implementing perimetry and interpreting test quality in the management of children with glaucoma. However, there remains a lack of agreement about defining progressive VF loss, and utilising perimetry over an individuals’ lifetime, highlighting the need for further research.

Download Full-text

Influence of implantations of extended depth-of-focus on standard automated perimetry

Scientific Reports ◽

10.1038/s41598-020-77214-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Jinhee Lee ◽

Yosai Mori ◽

Ryohei Nejima ◽

Keiichiro Minami ◽

Kazunori Miyata

Keyword(s):

Visual Field ◽

Cataract Surgery ◽

Mean Deviation ◽

Automated Perimetry ◽

Depth Of Focus ◽

Standard Automated Perimetry ◽

Multifocal Iol ◽

Reliability Indices ◽

Extended Depth Of Focus ◽

Foveal Sensitivity

AbstractThis prospective study aimed to investigate the influence of an extended depth-of-focus intraocular lens (EDOF IOL) on standard automated perimetry. Ninety eyes of 90 patients who had undergone cataract surgery from February 2018 to December 2018 were included. No patients had any diseases that might affect the visual field. ZMB00 (+ 4.00 D add), ZXR00V (+ 1.75 D add), and ZCB00V (Johnson & Johnson Surgical Vision, Santa Ana, CA, USA) were used as multifocal, EDOF, and monofocal IOLs, respectively. Humphrey Visual Field 10–2 testing was performed 2–3 months after cataract surgery, acceptable reliability indices were measured, and mean deviation (MD), pattern standard deviation (PSD), foveal sensitivity and mean sensitivity (MS) were compared. Seventy-one eyes (ZXR00V: 24 eyes, ZMB00: 25 eyes, ZCB00V: 22 eyes) were used for the analyses. The MD and MS of the EDOF and monofocal groups were significantly higher than those of the multifocal group (P < 0.0051). However, the MD and MS of the EDOF and monofocal groups were not different (P > 0.23). The PSD and foveal sensitivity were not different among the groups. In non-glaucomatous patients, the MD and MS of the EDOF IOL were comparable to those of the monofocal IOL and better than those of the multifocal IOL.

Download Full-text

Factors Predicting a Greater Likelihood of Poor Visual Field Reliability in Glaucoma Patients and Suspects

Translational Vision Science & Technology ◽

10.1167/tvst.9.1.4 ◽

2020 ◽

Vol 9 (1) ◽

pp. 4

Author(s):

Inas F. Aboobakar ◽

Jiangxia Wang ◽

Balwantray C. Chauhan ◽

Michael V. Boland ◽

David S. Friedman ◽

...

Keyword(s):

Visual Field ◽

Field Reliability

Download Full-text

Avoiding mask-related artefacts in visual field tests during the COVID-19 pandemic

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-318408 ◽

2021 ◽

pp. bjophthalmol-2020-318408

Author(s):

Marta Gómez Mariscal ◽

Francisco José Muñoz-Negrete ◽

Pablo Vicente Muñoz-Ramón ◽

Victor Aguado Casanova ◽

Laia Jaumandreu ◽

...

Keyword(s):

Visual Field ◽

Field Tests ◽

Face Mask ◽

Similar Rate ◽

Rank Test ◽

Adhesive Tape ◽

Test Duration ◽

Reliability Indices ◽

Surgical Masks ◽

Superior Border

AimsTo assess visual field (VF) pseudoprogression related to face mask use.MethodsWe reviewed a total of 307 VFs performed with a face mask (FPP2/KN95 or surgical masks) and compared them with prior VFs, performed before the pandemic. VFs with suspected pseudoprogression due to mask artefacts (VF test 1) were repeated with a surgical mask and an adhesive tape on its superior border (VF test 2) to distinguish from true VF loss. Several parameters including reliability indices, test duration, VF index (VFI), mean defect (MD) and pattern deviation probability plots were compared among last pre-COVID VFs, VF tests 1 and VF tests 2, using the Wilcoxon signed-rank test.ResultsWe identified 18 VFs with suspected progression artefact due to masks (5.8%). In all of them, the median VFI and MD significantly improved after fitting the superior border of the mask, showing no significant differences with pre-COVID tests. The median fixation losses were significantly higher when wearing the unfitted mask (13% vs 6%,p=0.047). The inferior hemifield was the most affected, either as a new scotoma or as an enlargement of a prior defect.ConclusionUnfitted masks can simulate VF progression in around 6% of cases, mainly in the inferior hemifield, and increase significantly the rate of fixation losses. A similar rate of artefacts was observed using FPP2/KN95 or surgical masks. The use of a surgical mask with an adhesive tape covering the superior border may reduce mask-related artefacts, although concomitant progression cannot be ruled out in all cases.

Download Full-text