Artifactual Visual Field Defects Identified on Technically "Reliable" Visual Field Studies in a Neuro-Ophthalmology...

Area of Science:

• Neuroscience
• Ophthalmology

Background:

• Automated visual field (AVF) testing is crucial for diagnosing neurological conditions affecting vision.
• Reliability indices in AVF testing aim to ensure accuracy, but discrepancies can occur.

Purpose of the Study:

• To evaluate the reliability of AVF studies showing neurological abnormalities but normal reliability indices.
• To investigate cases where AVF results were inconsistent with comprehensive neuro-ophthalmic assessments.

Main Methods:

• Retrospective observational study.
• Analysis of patient charts from a neuro-ophthalmologist at a tertiary referral center.
• Inclusion criteria focused on AVF abnormalities conflicting with clinical findings.

Main Results:

• Ten cases met inclusion criteria from 2230 charts.
• Eight cases showed no reproducible abnormality upon repeat testing.
• None of the patients developed convincing organic disease related to the visual field defect, despite some initially appearing to indicate bitemporal or homonymous hemianopia.

Conclusions:

• False-positive results can occur in automated visual field testing, even with seemingly reliable indices.
• Discrepancies between AVF results and clinical neuro-ophthalmic evaluation warrant caution.
• Repeating visual field studies is recommended when test results are inconsistent with the overall patient assessment.