Sensitivity and Specificity of Qualitative Visual Field Tests for Screening Visual Hemifield Deficits in...

Area of Science:

• Neurology
• Ophthalmology
• Stroke Medicine

Background:

• Visual hemifield deficits (VHFDs) significantly impact stroke patient diagnosis and treatment.
• Previous studies on qualitative visual field tests used heterogeneous patient samples, limiting stroke-specific data.
• There is a need for accurate, accessible screening tools for VHFDs in stroke patients.

Purpose of the Study:

• To determine the sensitivity and specificity of four qualitative visual field tests for screening VHFDs in right-brain-damaged (RBD) stroke patients.
• To evaluate the accuracy of individual tests and their combinations against standard automated perimetry (SAP).
• To introduce procedural improvements for enhanced screening accuracy.

Main Methods:

• Compared outcomes of face description, finger wiggle, and kinetic boundary perimetry tests with SAP in 67 RBD stroke patients.
• Calculated sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV).
• Assessed individual tests and combinations, including a novel kinetic boundary perimetry procedure.

Main Results:

• Kinetic boundary perimetry showed the highest individual test performance; face description had the lowest.
• No tested method produced false positives.
• The combination of the monocular static finger wiggle test (by quadrants) and kinetic boundary perimetry achieved 100% sensitivity and specificity.

Conclusions:

• The combination of finger wiggle and kinetic boundary perimetry is a highly accurate screening tool for VHFDs in RBD stroke patients.
• This combined approach prompts referral for formal visual field examination.
• It offers a quick, easy, and inexpensive method to improve stroke patient care and prognosis.