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False Positive Responses in Standard Automated Perimetry
Anders Heijl1, Vincent Michael Patella2, John G Flanagan3
1From Ophthalmology Research Unit, Department of Clinical Sciences Malmö, Lund University (A.H. and B.B.); Department of Ophthalmology, Skåne University Hospital, Malmö, Sweden (A.H.).
American Journal of Ophthalmology
|July 20, 2021
Summary
False positive rates in visual field testing show weak associations with results, except in severe glaucoma. Current guidelines for acceptable false positive ranges may need revision for better reliability assessment.
Area of Science:
- Ophthalmology
- Visual Neuroscience
Background:
- Standard automated perimetry is crucial for diagnosing and monitoring glaucoma.
- False positive (FP) responses can impact the reliability of visual field test results.
- Understanding the influence of FP rates on different perimetry algorithms is essential.
Purpose of the Study:
- To analyze the relationship between false positive (FP) response rates and standard automated perimetry outcomes.
- To evaluate the impact of FP rates on Swedish Interactive Thresholding Algorithm (SITA) Standard, SITA Fast, and SITA Faster.
- To compare the influence of FP rates with general height (GH) on perimetric results.
Main Methods:
- A prospective multicenter cross-sectional study involving 126 patients with glaucoma.
- Testing with SITA Standard, SITA Fast, and SITA Faster across two visits.
- Calculating intervisit differences in mean deviation (MD), visual field index (VFI), and significant test points as a function of FP rates and GH.
Main Results:
- Increasing FP rates showed small associations with higher MD and VFI values across all algorithms.
- FP rates explained only small portions of intervisit differences (r² 0.00-0.11).
- FP effects were more pronounced in severe glaucoma, while GH showed a stronger relationship with outcomes than FP.
Conclusions:
- False positive rates have weak associations with visual field test results, except in severe glaucoma.
- Current recommendations for acceptable FP ranges may require revision.
- General height or alternative analyses might be more effective than FP rates for identifying unreliable visual field tests.
