Adi Orbach1, Ghee Soon Ang1, Andrew S Camp2, Derek S Welsbie2, Felipe A Medeiros3, Christopher A Girkin4, Massimo A Fazio4, Won Hyuk Oh2, Robert N Weinreb2, Linda M Zangwill2, Zhichao Wu5. 1. From the Centre for Eye Research Australia (A.O., G.S.A., Z.W.), Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia. 2. Hamilton Glaucoma Center (A.S.C., D.S.W., W.H.O., R.N.W., L.M.Z.), Viterbi Family Department of Ophthalmology, University of California, San Diego, La Jolla, California. 3. Duke Eye Center and Department of Ophthalmology (F.A.M.), Duke University School of Medicine, Durham, North Carolina. 4. Department of Ophthalmology and Visual Sciences (C.A.G., M.A.F.), University of Alabama at Birmingham, Birmingham, Alabama. 5. From the Centre for Eye Research Australia (A.O., G.S.A., Z.W.), Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Ophthalmology, Department of Surgery (Z.W.), The University of Melbourne, Melbourne, Victoria, Australia.. Electronic address: wu.z@unimelb.edu.au.
Abstract
PURPOSE: To examine whether glaucomatous central visual field abnormalities can be more effectively detected using a qualitative, expert evaluation of the 10-2 test compared with the topographically corresponding central 12 locations of the 24-2 test (C24-2). DESIGN: Cross-sectional study. METHODS: Eyes with a glaucomatous optic nerve appearance or ocular hypertension (n = 523) and healthy eyes (n = 107) were included as cases and control subjects, respectively. The 10-2 and C24-2 visual field results of all eyes were graded by 4 glaucoma specialists for the probability that central visual field abnormalities were present. RESULTS: The sensitivity of the 10-2 and C24-2 tests for detecting the cases at 95% specificity were not significantly different (e.g., 32.2% and 31.4%, respectively, for grader 1, P = .87; all graders P ≥ .25). At 95% specificity, the pattern standard deviation values from these tests had a similar sensitivity to the qualitative evaluation for the C24-2 test for all graders (P ≥ .083), but it had a significantly higher sensitivity than the qualitative evaluation for the 10-2 test for 3 graders (P ≤ .016). CONCLUSIONS: The similarity in performance of the 10-2 and C24-2 test suggests that the increased sampling density of the former does not significantly improve the detection of central visual field abnormalities, even when based on expert assessment. These findings should not be taken to mean that the 10-2 test is not useful, but it underscores the need for its utility to be clearly established before incorporating it as routine glaucoma standard of care.
PURPOSE: To examine whether glaucomatous central visual field abnormalities can be more effectively detected using a qualitative, expert evaluation of the 10-2 test compared with the topographically corresponding central 12 locations of the 24-2 test (C24-2). DESIGN: Cross-sectional study. METHODS: Eyes with a glaucomatous optic nerve appearance or ocular hypertension (n = 523) and healthy eyes (n = 107) were included as cases and control subjects, respectively. The 10-2 and C24-2 visual field results of all eyes were graded by 4 glaucoma specialists for the probability that central visual field abnormalities were present. RESULTS: The sensitivity of the 10-2 and C24-2 tests for detecting the cases at 95% specificity were not significantly different (e.g., 32.2% and 31.4%, respectively, for grader 1, P = .87; all graders P ≥ .25). At 95% specificity, the pattern standard deviation values from these tests had a similar sensitivity to the qualitative evaluation for the C24-2 test for all graders (P ≥ .083), but it had a significantly higher sensitivity than the qualitative evaluation for the 10-2 test for 3 graders (P ≤ .016). CONCLUSIONS: The similarity in performance of the 10-2 and C24-2 test suggests that the increased sampling density of the former does not significantly improve the detection of central visual field abnormalities, even when based on expert assessment. These findings should not be taken to mean that the 10-2 test is not useful, but it underscores the need for its utility to be clearly established before incorporating it as routine glaucoma standard of care.
Authors: Lyne Racette; Jeffrey M Liebmann; Christopher A Girkin; Linda M Zangwill; Sonia Jain; Lida M Becerra; Felipe A Medeiros; Christopher Bowd; Robert N Weinreb; Catherine Boden; Pamela A Sample Journal: Arch Ophthalmol Date: 2010-05
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