Factors Associated With Visual Field Testing Reliability in Children With Glaucoma or Suspected Glaucoma

Area of Science:

• Ophthalmology
• Pediatric Glaucoma Research
• Visual Field Testing

Background:

• The Humphrey Visual Field (HVF) test is crucial for diagnosing and monitoring glaucoma.
• Assessing HVF test reliability in pediatric populations is essential for accurate diagnosis and management.
• Limited data exists on factors influencing HVF reliability in children with glaucoma or glaucoma suspects.

Purpose of the Study:

• To evaluate the reliability of Humphrey Visual Field (HVF) testing in children diagnosed with glaucoma or considered glaucoma suspects.
• To identify demographic and clinical risk factors associated with unreliable HVF test results in this pediatric cohort.

Main Methods:

• Retrospective cohort study analyzing 634 HVF 24-2 tests from 136 pediatric patients (≤18 years) with glaucoma or glaucoma suspect.
• Data extracted included age, primary language, visual acuity (VA), and glaucoma diagnosis.
• Multivariable regression models assessed factors associated with test-level and patient-level reliability.

Main Results:

• Overall HVF test reliability was 51.3%.
• Older age, better baseline visual acuity (VA), and English as primary language were associated with increased test reliability (P < .04).
• Patient-level reliability scores showed similar associations, with no significant learning effect observed from repeated testing.

Conclusions:

• HVF test reliability in children with glaucoma is suboptimal, with younger age, poorer visual acuity, and non-English primary language being significant risk factors.
• Clinicians should carefully consider these factors when interpreting HVF results in pediatric glaucoma patients.
• The findings highlight the need for tailored approaches to optimize visual field testing in children.