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Variability and Power to Detect Progression of Different Visual Field Patterns.
Fernanda N Susanna1, Bruna Melchior2, Jayter S Paula3
1Department of Ophthalmology, University of Sao Paulo School of Medicine, São Paulo, SP, Brazil; Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York.
Ophthalmology. Glaucoma
|April 13, 2021
Summary
The 10-2 visual field (VF) test detects glaucoma progression faster than the 24-2 test due to lower variability. This finding supports using the 10-2 VF test for managing glaucoma patients and designing clinical trials.
Area of Science:
- Ophthalmology
- Visual Neuroscience
Background:
- Glaucoma is a leading cause of irreversible blindness.
- Early detection and monitoring of visual field (VF) progression are crucial for managing glaucoma and preventing vision loss.
- Different VF testing protocols, such as the 24-2 and 10-2 tests, have varying sensitivities and variabilities.
Purpose of the Study:
- To compare the variability and ability to detect visual field (VF) progression between the standard 24-2, the central 12 locations of the 24-2 (central 24-2), and the 10-2 VF tests in eyes with existing VF abnormalities.
- To determine the time required to detect significant VF progression using these different testing patterns.
Main Methods:
- Retrospective analysis of a large, multisite cohort including 52,806 24-2 and 11,966 10-2 VF tests from 7,307 eyes with at least 5 visits and 2 years of follow-up.
- Linear regression models were used to calculate the rates of mean deviation (MD) change (slopes) and assess variability using residuals.
- Computer simulations (n=10,000) estimated the power to detect significant progression at various MD change rates.
Main Results:
- Mean deviation (MD) variability was highest in the -5 to -20 decibel (dB) range for all tested patterns.
- The 10-2 VF test demonstrated consistently lower MD variability compared to the 24-2 and central 24-2 tests.
- The time to detect confirmed significant progression (at 80% power) was shortest with the 10-2 VF test, showing a 14.6%–18.5% reduction compared to the 24-2 test and a 22.9%–26.5% reduction compared to the central 24-2 test.
Conclusions:
- The 10-2 VF test is more effective in reducing the time to detect central visual field progression in glaucoma eyes compared to the 24-2 and central 24-2 tests.
- Lower variability of the 10-2 test contributes to its enhanced ability to detect progression.
- These findings highlight the potential clinical value of the 10-2 VF test in glaucoma management and clinical trial design.
