Agreement Between 10-2 and 24-2C Visual Field Test Protocols for Detecting Glaucomatous Central Visual Field Defects

Area of Science:

• Ophthalmology
• Optometry
• Medical Technology

Background:

• Glaucoma management relies on accurate visual field (VF) testing.
• Detecting central visual field defects (CVFDs) is crucial for early glaucoma diagnosis and monitoring.
• Current perimetry protocols may have limitations in efficiency for comprehensive glaucoma assessment.

Purpose of the Study:

• To assess the agreement between Humphrey Visual Field Analyzer 10-2 and 24-2C test protocols.
• To evaluate the efficacy of these protocols in detecting glaucomatous defects within the central 10 degrees of the visual field (CVFDs).

Main Methods:

• Included VFs from 165 eyes (healthy, glaucoma suspects, glaucoma patients).
• Utilized 10-2 and 24-2C VF testing protocols within a 6-month period.
• Defined CVFDs based on specific criteria for contiguous points on total deviation (TD) and pattern deviation (PD) plots.
• Employed Cohen kappa (k) for agreement assessment and evaluated specificity in healthy eyes.

Main Results:

• Moderate to substantial agreement was observed between 10-2 and 24-2C grids for detecting CVFDs (PD: k=0.551, TD: k=0.651).
• High specificity (0.94-1.0) was noted for both protocols in healthy eyes.
• CVFDs were localized to superior, inferior, or both hemifields.

Conclusions:

• Substantial agreement between 24-2C and 10-2 protocols supports their combined use.
• Adding central test points to the 24-2 test grid may streamline perimetry.
• This approach could potentially eliminate the need for separate testing regimens for central and peripheral glaucomatous VF damage.