Evaluation of adaptive spatial enhancement in suprathreshold visual field screening.

Sixty-three normal subjects and 94 abnormal patients, most of whom had glaucoma, were tested in the central visual field using a threshold-related, eccentricity-compensated, spatially adaptive suprathreshold screening program and a full-threshold program on the Humphrey field analyzer. The initial stimulus locations on the screening test were identical to those of the threshold test; additional screening stimuli were presented surrounding each missed initial stimulus. Surprisingly, this spatial enhancement strategy did not improve sensitivity or specificity rates of the screening beyond that achieved by considering the initial stimulus locations alone. Points missed during screening often showed a depressed sensitivity rate (measured threshold greater than 6 dB below the age-corrected normal reference value) in the same area of the threshold field. This was true in fields from abnormal and normal subjects. This finding of persistent shallow defects in the same test session among otherwise normal persons has disturbing implications for the importance of "confirmed" defects in the diagnosis of disease.

RCT Entities:   Population Interventions Outcomes