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Diagnostic accuracy of confrontation visual field tests.
N M Kerr1, S S L Chew, E K Eady
1Department of Ophthalmology, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand.
Neurology
|April 14, 2010
Summary
Confrontation visual field tests are insensitive for detecting vision loss individually. Combining tests, like kinetic red target with finger wiggle, improves sensitivity for better screening.
Area of Science:
- Ophthalmology
- Diagnostic Accuracy
- Visual Field Testing
Background:
- Confrontation visual field testing is a common clinical method.
- Its diagnostic accuracy for detecting visual field loss is not well-established.
- Automated perimetry serves as a gold standard for visual field assessment.
Purpose of the Study:
- To evaluate the diagnostic accuracy of individual and combined confrontation visual field tests.
- To compare the performance of various confrontation testing methods.
Main Methods:
- Prospective recruitment of 163 patients from ophthalmology clinics.
- Comparison of 7 common confrontation visual field tests against SITA-standard 24-2 Humphrey visual field analysis.
- Calculation of sensitivity, specificity, and predictive values for each test and combination.
Main Results:
- Most individual confrontation tests showed low sensitivity for detecting visual field loss.
- Kinetic testing with a red target offered the highest individual sensitivity (74.4%) and specificity (93.0%).
- Combining kinetic red target with static finger wiggle testing yielded 78.3% sensitivity and 90.1% specificity.
Conclusions:
- Individual confrontation visual field tests are poor screening tools due to low sensitivity.
- Combining confrontation tests offers a practical approach to enhance detection sensitivity for visual field defects.
