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Ava K. Bittner, Mian Haris Iftikhar, Gislin Dagnelie; Test-Retest, Within-Visit Variability of Goldmann Visual Fields in Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2011;52(11):8042-8046. doi: https://doi.org/10.1167/iovs.11-8321.
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Reliable outcome measures are needed to estimate changes in peripheral vision during future treatment clinical trials for retinal degeneration patients. The authors examined the short-term variability of Goldmann visual field (GVF) results converted to retinal areas in retinitis pigmentosa (RP) subjects.
Two within-visit GVFs were obtained from one eye each of 37 RP subjects with visual acuity better than 20/400 by a single experienced operator using the V4e (n = 28) or III4e (n = 12) target, or both. Planimetric GVF measures were digitized and converted to retinal areas in square millimeters by a single independent user. The 95% coefficient of repeatability (CR.95) for percentage change in central retinal area was determined from the test-retest difference.
There were no significant systematic trends toward either increase or decrease between the first and second GVF. For the III4e target, the CR.95 was 23.7% on average across all 12 subjects. For the V4e target, the CR.95 was 32.8% on average across all 28 subjects. However, 3 of 8 subjects with a geometric mean retinal area <10 mm2 (∼7° radius) for the V4e target exhibited unusually large variability (50%–100%), and the CR.95 was 19.2% when these three subjects were excluded. Variability was not statistically significantly related to visual acuity, age, presence of cystoid macular edema, or subjects' stress or anxiety levels.
Inherent test-retest variability (CR.95) of functional retinal areas derived from GVF results in a clinical RP population can be limited to <20% by using a single experienced operator, making the GVF the measure of choice for changes in peripheral vision.
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