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Related Experiment Videos

Mean deviation fluctuation in eyes with stable Humphrey 24-2 visual fields.

C L Tattersall1, S A Vernon, G J Menon

  • 1Directorate of Ophthalmology, Queen's Medical Centre, Nottingham, UK. clt06@aol.com

Eye (London, England)
|January 21, 2006
PubMed
Summary

Glaucoma progression can be diagnosed by monitoring visual field Mean Deviation (MD) scores. Small fluctuations are expected in stable eyes, but significant changes beyond the 99% confidence interval may indicate disease advancement.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Clinical Neuroscience

Background:

  • Glaucoma is a leading cause of irreversible blindness worldwide.
  • Accurate diagnosis of glaucomatous progression is crucial for timely intervention.
  • Visual field testing is a key method for monitoring glaucoma, but understanding expected fluctuations is vital.

Purpose of the Study:

  • To establish expected fluctuations in Mean Deviation (MD) scores for stable visual field defects.
  • To provide clinicians with a tool for diagnosing glaucomatous progression more accurately.
  • To correlate visual field defect severity with the expected range of MD score variation.

Main Methods:

  • Analysis of 1010 Humphrey 24-2 visual fields from 202 patients with stable glaucoma over at least 3 years.

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  • Scoring of visual fields using the Advanced Glaucoma Intervention Study (AGIS) system.
  • Calculation of 99% confidence intervals (CI) for MD score fluctuations across different grades of visual field defects.

    • Main Results:

    • The 99% CI for MD score fluctuations ranged from 0.3 dB (no defect) to 1.3 dB (end-stage defects).
    • A strong positive correlation (r=0.7, P=0.0003) was observed between the CI and the grade of visual field defect.
    • Minimal fluctuation (P=0.96) was found across all defect stages in stable eyes.

    Conclusions:

    • Clinicians should expect minimal MD score fluctuation in reliable visual fields of stable eyes.
    • An increase in MD beyond the established 99% CI may indicate glaucomatous progression.
    • Visual field test reliability indices are paramount for accurate glaucoma assessment.