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Ananth C. Viswanathan, Trishal Boodhna, Jonathan Clarke; The PROGRESSOR Database: How Well Does The Initial Binocular Visual Field Predict The Second One?. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5730.
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© ARVO (1962-2015); The Authors (2016-present)
To analyze how initial visual fields perform at predicting future functional visual field loss.
138,597 visual fields dated from 1989 to 2010 were sourced from the PROGRESSOR database in order to construct binocular Integrated Visual Fields (IVFs). 24,752 IVFs were consequently derived to produce an IVF database. The database was examined to find the proportions of IVFs that passed or failed a test separating subjects with normal functional vision from those with defective binocular vision at initial presentations (defined as at least one point in the IVF matrix with a sensitivity of less than 10 dB). Those that passed initial IVF testing were examined to find the proportion passing or failing the test at second IVF observation and this was repeated for those that failed the initial IVF test.
At first IVF presentation, 90.4% of subjects were found to have defective binocular vision with 9.6% found to have normal functional binocular vision. Of those who failed the initial test, 95.1% failed the second binocular defect test with 4.5% passing the second test. In subjects who passed the initial test, 55.5% failed the second test whilst 44.5% passed. The Positive Predictive Value of an initial defective IVF for a second defective one was 95.1%. The Negative Predictive Value was 44.5%. The mean intertest interval was quite large (717 days) but the dispersion was also large (SD 652 days).
An initial defective Integrated Visual Field is a good predictor of a second defective one. The majority of patients who passed their first test and therefore appeared to have normal functional vision at first IVF observation went on to fail the functional binocular vision test at second observation. This result may be partially explained by glaucoma progression. A minimum of two IVFs may be necessary in order to increase the efficiency of identification of binocular defects.
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