Factors associated with a learning effect in glaucoma patients using automated perimetry

Area of Science:

• Ophthalmology
• Visual Psychophysics

Background:

• The learning effect in visual field testing can impact diagnostic accuracy.
• Understanding factors influencing this effect is crucial for reliable glaucoma assessment.

Purpose of the Study:

• To identify factors associated with a learning effect between the first two Humphrey Field Analyzer (HFA) visual field exams in primary open-angle glaucoma (POAG) patients.
• To determine if patient characteristics or initial test parameters predict learning between serial visual field tests.

Main Methods:

• Retrospective analysis of 45 POAG patients undergoing HFA program 30-2.
• Comparison of visual field parameters between the first and second examinations.
• Statistical analysis to correlate learning effect with patient demographics, test intervals, and initial field parameters.

Main Results:

• A significant average decrease of 1.7 dB in mean defect was observed between the first two visual field exams (P < 0.05).
• No significant learning effect differences were found based on time interval, tested field area, age, sex, race, or prior perimetric experience.
• Initial exam parameters showed positive correlation with learning for defect depth and negative correlation for fixation losses (P < 0.05) in patients retested within seven months.

Conclusions:

• Predicting which glaucoma patients require a second baseline visual field exam to rule out learning effects is challenging.
• Patients with deeper glaucomatous field loss or fewer fixation losses may exhibit a learning effect, especially if retested within six months.