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Study of Optimal Perimetric Testing In Children (OPTIC): Normative Visual Field Values in Children
Dipesh E Patel1, Phillippa M Cumberland2, Bronwen C Walters3
1Life Course Epidemiology and Biostatistics Section, University College London Institute of Child Health, London, UK; Ulverscroft Vision Research Group, London, UK; Moorfields Eye Hospital NHS Foundation Trust, London, UK; Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Purpose:
We sought to define normative visual field (VF) values for children using common clinical test protocols for kinetic and static perimetry.
Design:
Prospective, observational study.
Subjects:
We recruited 154 children aged 5 to 15 years without any ophthalmic condition that would affect the VF (controls) from pediatric clinics at Moorfields Eye Hospital.
Methods:
Children performed perimetric assessments in a randomized order using Goldmann and Octopus kinetic perimetry, and Humphrey static perimetry (Swedish Interactive Thresholding Algorithm [SITA] 24-2 FAST), in a single sitting, using standardized clinical protocols, with assessment by a single examiner. Unreliable results (assessed qualitatively) were excluded from the normative data analysis. Linear, piecewise, and quantile mixed-effects regression models were used. We developed a method to display age-specific normative isopters graphically on a VF plot to aid interpretation.
Main Outcome Measures:
Summary measures and graphical plots describing normative VF data for 3 common perimetric tests.
Results:
Visual field area increased with age on testing with Goldmann isopters III4e, I4e, and I2e (linear regression; P < 0.001) and for Octopus isopters III4e and I4e (linear regression; P < 0.005). Visual field development occurs predominately in the inferotemporal field. Humphrey mean deviation (MD) showed an increase of 0.3 decibels (dB; 95% CI, 0.21-0.40) MD per year up to 12 years of age, when adult MD values were reached and thereafter maintained.
Conclusions:
Visual field size and sensitivity increase with age in patterns that are specific to the perimetric approach used. These developmental changes should be accounted for when interpreting perimetric test results in children, particularly when monitoring change over time.
