Posters

Role of visual reliability indices in detecting glaucoma progression

Poster Details

First Author: P.Raman MALAYSIA

Co Author(s):                        

Abstract Details

Purpose:

The influence of visual field reliability indices, beyond the manufacturer recommended limits, on detecting glaucoma progression has been sparsely studied. We aim to evaluate the impact of fixation loss(FL), false positive (FP) and false negative (FN ) in detecting glaucoma progression

Setting:

Hospital Tuanku Ampuan Najihah, Kuala Pilah Malaysia

Methods:

A retrospective study on 415 VFs taken from 88 eyes of 45 patients which showed structural glaucoma progression over 5 years. The VFs were obtained utilizing the Humphrey Field Analyser II using 24-2 SITA protocol. No eyes or VFs were excluded because of poor reliability indices. Glaucomatous visual field progression was defined by an annual decrease in MD slope by a minimum of 1dB per year. Linear regression models were used to evaluate the associations between reliability indices and false negative detection of glaucoma progression on VF.

Results:

Median FL, FP, and FN response rates were 18.6%, 1.3%, and 9.6%, respectively. There were 33 patients with more than 3 reliable VF results (FL <20% and FP response rate <15%).VF progression seen in 57 eyes (78%). Using the linear regression model, it can be predicted that with every 10% increase in FP, MD increases by 1dB, while every 10% increase in FN decreases MD by 1.72dB. The logistic regression model showed that every 1% increase in FP and FN false-negatively predicts glaucoma progression by 1.35 times and 1.55 times respectively.

Conclusions:

FL does not have significant impact on VF reliability in established glaucoma. Any level of FP or FN decreases VF reliability. FN has more of an impact on VF reliability than FP. We recommend to off fixation and monitor reliability via alternate methods like gaze tracking to improve the detection rate of glaucoma progression through visual fields.

Financial Disclosure:

None