Real-World Analysis of the Aging Effects on Visual Field Reliability Indices in Humans

Relationships between age and visual field (VF) reliability indices were investigated using a large real-world dataset (42,421 VF data points from 11,525 eyes of 5930 subjects). All VFs tested and stored at Shimane University Hospital between 1988 and 2019 were exported. Correlations between age, mean deviation (MD), pattern standard deviation (PSD), and reliability indices including fixation losses (FLs), false negatives (FNs), and false positives (FPs) were analyzed. The mean ± standard deviation age was 65.0 ± 15.1 years; MD--6.9 ± 8.1 decibels (dB); PSD-6.3 ± 4.6 dB; FL-8.6 ± 11.7%; FN-5.3 ± 8.3%; and FP-2.6 ± 5.0%. Univariate analyses showed strong associations between age and FNs (correlation coefficient, ρ = 0.20, p < 0.0001) and MD (ρ = -0.21, p < 0.0001). All FLs, FNs, and FPs were lowest during the third decade (20-29 years) of life. FLs were elevated consistently after that decade, and FNs were elevated sharply after the seventh decade. FPs were relatively stable after the fourth decade (30-39 years). Mixed-effect regression analyses in subjects 40 years and older showed that older age was associated with worse FLs (p < 0.0001) and FNs (p < 0.0001) but not FPs (p = 0.4126). Aging affects FLs and FNs with different modes but had minimal effects on FPs. Decreased VF sensitivity, deteriorated macular function, and technical difficulties with testing may be mechanisms of age-related changes in FLs and FNs.