April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Integrated Visual Field Measures Provide a Better Estimate of Patient Visual Field Severity Than Mean Deviation in the Better Eye
R. Asaoka; D. Crabb; T. Yamashita; R. Russell; Y. Wang; D. Garway-Heath
Author Affiliations & Notes
  • R. Asaoka
    Optometry and Visual Science, City University London, London, United Kingdom
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
  • D. Crabb
    Optometry and Visual Science, City University London, London, United Kingdom
  • T. Yamashita
    Glaucoma Research Unit,
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
  • R. Russell
    Glaucoma Research Unit,
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
  • Y. Wang
    Glaucoma Research Unit,
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
  • D. Garway-Heath
    Glaucoma Research Unit,
    NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
    GB Bietti Foundation for Research in Ophthalmology - IRCCS, Rome, Italy
  • Footnotes
    Commercial Relationships  R. Asaoka, None; D. Crabb, None; T. Yamashita, None; R. Russell, None; Y. Wang, None; D. Garway-Heath, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4330. doi:
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      R. Asaoka, D. Crabb, T. Yamashita, R. Russell, Y. Wang, D. Garway-Heath; Integrated Visual Field Measures Provide a Better Estimate of Patient Visual Field Severity Than Mean Deviation in the Better Eye. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4330.

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Abstract

Purpose: : The Humphrey Mean Deviation (MD) and Visual Field Index (VFI) describe visual field (VF) loss severity in an eye rather than a patient. These monocular measures, particularly in the better eye, are typically used in the clinic to gauge the severity of patient impairment. This study tests the hypothesis that a measure based on the Binocular Integrated Visual Field (IVF) [1,2] provides a different estimate of a patient’s VF severity than a ‘per eye’ measure (MD in the better eye).

Methods: : Humphrey visual field charts (24-2 SITA standard) from 68 consecutive patients in a normal tension glaucoma clinic were retrospectively examined (mean age: 66, range [31, 88] years). The better MD from the two eyes was recorded. IVFs were constructed for each patient by merging monocular VFs. An average of total deviation values in the IVF generated the IVF MD. The differences between better-eye MD and IVF MD were assessed.

Results: : The average IVF MD was significantly better than average better-eye MD (mean difference 1.3 dB, 95% confidence interval [CI]: 1.0 to 1.7 dB, P<0.001). Twenty-five percent of the patients had an IVF MD that was at least 2dB healthier than the MD in the better eye (95% CI: 15 to 37 %). There was significant linear association between the differences in better-eye and IVF MD against the severity of VF defect (P<0.001, R2=0.44).

Conclusions: : Using the MD in the better eye gives the impression that the patient’s VF loss severity is worse than if a binocular measure is used. These differences are more pronounced in patients with advanced defects and especially where there is asymmetry in the scotoma between eyes. The IVF offers a rapid assessment of a patient’s VF severity without extra binocular testing.[1] Crabb DP et al. Br J Ophthalmol. 2004 Sep;88:1191-6. [2] Crabb DP et al. Br J Ophthalmol. 1998;82:1236-41.

Keywords: visual fields • binocular vision/stereopsis • quality of life 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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