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Full-field stimulus threshold testing: a scoping review of current practice.

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Summary

Standardized full-field stimulus threshold (FST) measurement is needed for retinal light sensitivity testing. Variability in FST methods hinders clinical interpretation and trial comparisons, highlighting a need for consistent reporting and paediatric considerations.

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Area of Science:

  • Ophthalmology
  • Psychophysics
  • Clinical Trials

Background:

  • Full-field stimulus threshold (FST) measures whole-field retinal light sensitivity.
  • FST assesses visual function in severe retinal disease and is used in clinical trials.
  • Growing use in clinics lacks standardized guidance for FST measurement.

Purpose of the Study:

  • To explore variability in FST conduct and reporting.
  • To inform evidence synthesis and consensus guidance for FST.
  • To identify needs for standardized FST methodology.

Main Methods:

  • Scoping review following PRISMA-ScR guidelines.
  • Comprehensive literature search and data extraction from 85 sources.
  • Qualitative and quantitative comparison of FST methodology and outcomes.

Main Results:

  • Significant variability exists in FST methodology (luminance, color, duration, test strategy, dark adaptation).
  • Insufficient reporting hinders cross-center comparison and interpretation of clinical significance.
  • An unmet need for pediatric-specific FST considerations was identified.

Conclusions:

  • Standardized guidance for FST methodology is required.
  • Consistent reporting of core elements, like flash luminance equivalence, is a crucial first step.
  • Quality assurance, calibration, and age-appropriate reference data are needed to strengthen FST rigor.