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Trishal Boodhna, Jonathan Clarke, Ananth Viswanathan; The Progressor Database: Perimetric Learning Effects In The Real World. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5517. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Investigation into the possible masking of visual field (VF) progression by perimetric learning effects
138,597 visual fields from the PROGRESSOR database of the Glaucoma Service of Moorfields Eye Hospital, London were examined for inclusion resulting in 8,278 eyes providing 41,390 visual fields. To be included in the study, subjects were required to be 18 years of age at first visual field and required to have undertaken at least four visual field test sessions. Sample means for mean sensitivity (MS) were calculated per test session with mean MSs analysed for the possible existence of learning effects.
Differences in terms of MS between the first and second visual fields were found to be insignificant. However significant differences between the second and third visual fields (-0.31 dB, P=0.001, ANOVA) and third and fourth visual fields (-0.24 dB, P=0.039, ANOVA) were observed. When data were stratified by MD, no significant changes in MS were observed across test sessions for "healthy VFs" (MD≥0 dB) whilst for "damaged VFs" (MD≤-2 dB), no significant changes were observed between the first and second and second and third visual fields. Significant changes observed between the third and fourth periods (P=0.041, ANOVA).
In the whole dataset, no decline in MS was observed between VF1 and VF2. Given that the dataset is predominantly composed of glaucoma patients, the absence of deterioration suggests a possible learning effect. Stratification by MD suggests learning effects may be prolonged in more damaged VFs.
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