Assessment of an effective visual field testing strategy for a normal pediatric population

To investigate which visual field testing strategy yields more reliable and tolerable field analysis in a normal pediatric population.

68 healthy children aged 6-13 years with no ocular or systemic diseases were included in the study. One randomly selected eye of each child underwent standard achromatic visual field analysis using a Model 750 Humphrey Field Analyzer II (Carl Zeiss Meditec, Dublin, Calif., USA). We evaluated the reliability criteria (false negative, false positive and fixation loss scores) and the duration of the visual field tests performed by Fastpac (with stimulus sizes III and V, respectively) and SITA Fast with stimulus size III. Moreover, subjects underwent Goldmann perimetry testing with stimulus V. Ability to complete the perimetry tests was also scored. Perimetric analysis was stopped before the end if signs of fatigue appeared. Mean sensitivity, mean defect and pattern standard deviation were recorded for automated tests.

All subjects but 8 successfully completed each of four tests. The mean duration of the tests was 4.23, 5.46, 6.35 and 11.06 min for SITA Fast with stimulus size III, Fastpac with stimulus size V, Size III and Goldmann perimetry, respectively (p < 0.001). Both false-negative and false-positive test scores were found to be significantly lower for SITA Fast with stimulus size III compared to the other automated tests (p < 0.01). Children older than 8 years (n = 35) achieved significantly higher test reliability scores (p < 0.01).

As early detection of structural and functional visual abnormalities may be of utmost importance in the pediatric population considering many potentially serious neurological and ocular problems met with, accurate and reproducible visual field testing is vital. To achieve this goal, visual field testing with SITA Fast algorithm seemed to be a promising strategy for a pediatric population in a typical clinical setting.