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Heather Gauger, Erin Jenewein, Dominique Larman, Ava Bittner; A More Engaging Visual Field Test to Increase Use and Reliability in Pediatrics. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5181.
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© ARVO (1962-2015); The Authors (2016-present)
We created a prototype device to make visual field (VF) testing more engaging for young children, thus increasing their attention and consistency of responses to test stimuli, which in turn should improve VF reliability. Poor VF reliability has been a longstanding, major issue since it leads to an increased number of tests and/or longer time to determine true vision losses. VF tests are rarely obtained in children since inconsistent results are of doubtful value and challenging to interpret.
Children between ages 5-8 who are glaucoma suspects or have low vision were randomized to complete Humphrey VF testing with the video/audio intervention (n=4) versus without (i.e., usual care; n=3) in each eye at two visits ~1 week apart. The intervention includes a 1.5” micro-display video screen displaying popular cartoon characters as the fixation target and audio clips of an impersonated cartoony voice, presented by the test operator to provide instructional feedback during testing.
Mean false positive responses during VF testing at both visits were statistically significantly greater by 10% on average in children randomized to usual care testing compared to those who received the intervention (95% CI: 1-18%; p=0.03) after adjusting for age group and eye. At the second visit, intervention group subjects had 9% fewer false negatives for the second eye tested compared to the first eye, whereas usual care controls had 8% greater false negatives for the second eye (95% CI: -2% to 35%; p=0.07). Additional children are scheduled for study testing to increase the sample size and allow us to explore intervention effects on the reliability of VF mean deviation scores.
False positives affect the accuracy and reliability of VF results; reductions with our novel intervention could translate to improved diagnosis and care for young childrens' peripheral vision loss.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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