Lens rim artifact in automated threshold perimetry

Area of Science:

• Ophthalmology
• Optometry
• Visual Science

Background:

• Central static threshold visual fields are crucial for diagnosing visual impairments.
• Corrective lenses used during visual field testing can introduce artifacts.
• Lens rim artifact (LRA) is a known, yet often overlooked, issue in visual field interpretation.

Purpose of the Study:

• To determine the prevalence of lens rim artifact (LRA) in Humphrey 30-2 Program visual fields.
• To identify the common presentations and interpretational errors associated with LRA.
• To explore risk factors and provide recommendations for minimizing LRA.

Main Methods:

• Retrospective and prospective analysis of 704 and 276 Humphrey 30-2 Program visual fields, respectively.
• Evaluation of artifact presentation, including location and type of visual defects.
• Correlation of LRA with patient demographics, refractive error, and testing parameters.

Main Results:

• LRA was present in 10.4% (retrospective) and 6.2% (prospective) of visual fields.
• LRA commonly manifested as temporal quadrant defects, leading to overdiagnosis (5 types) and underdiagnosis (2 types) of visual field loss.
• Older age, high hyperopic correction, and specific perimeter limitations were identified as risk factors.

Conclusions:

• Lens rim artifact is a significant factor affecting the accuracy of Humphrey 30-2 Program visual field testing.
• Specific temporal field defects at 27 degrees eccentricity may be disregarded as they are solely due to LRA.
• Minimizing LRA occurrence and understanding its impact are essential for accurate visual field interpretation.