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Brightness discrimination test is not useful in screening for open angle glaucoma
1Department of Ophthalmology, Schell Eye Hospital, Christian Medical College and Hospital, Vellore, India.
Journal of Glaucoma
|June 1, 1996
Summary
The brightness discrimination test (BDT) is not reliable for diagnosing primary open angle glaucoma (POAG). This vision test showed poor association with glaucoma-related visual field defects.
Area of Science:
- Ophthalmology
- Optometry
- Clinical Diagnosis
Background:
- Brightness discrimination test (BDT) is used to evaluate optic nerve dysfunction.
- It has been proposed as a screening tool for primary open angle glaucoma (POAG).
Purpose of the Study:
- To assess the reliability and validity of the BDT in diagnosing POAG.
- To determine if BDT can accurately detect visual field defects associated with glaucoma.
Main Methods:
- 34 POAG patients, 20 glaucoma suspects, and 33 controls were studied.
- BDT was performed by two independent observers, showing excellent interobserver agreement (Kappa 0.84).
- Cataracts were not an exclusion criterion.
Main Results:
- BDT demonstrated low sensitivity (67%) and specificity (93%) for POAG diagnosis.
- Its ability to detect significant field defects was also poor (sensitivity 53%, specificity 76%).
- Cataracts significantly impacted brightness scores, confounding glaucoma assessment.
Conclusions:
- BDT showed poor association with asymmetrical field defects detected by Humphrey's field analyzer (HFA).
- The BDT is not a useful diagnostic tool for POAG, especially in the presence of cataracts.