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C. F. Brito, K. R. Woodward, C. A. Johnson, C. K. Doyle, M. Wall; Reduction of Learning Effects in Studies of Multiple Parametric Tests in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1625.
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To examine how learning effects (performance improvements due to repeated testing) vary in glaucoma patients across four perimetry tests: size III SITA and size V full threshold methods of the Humphrey Field Analyzer (HFA), as well as Matrix and Motion Perimetry (MP).
About once a week for five weeks glaucoma patients (N=30) were given four perimetric tests: (1) HVA SITA standard Size III, (2) HVA Full-threshold Size V, (3) MP, and (4) Matrix. Participants had previous experience with perimetric testing. Each participant first received a SITA test (used for study eligibility) followed by the remaining three tests, administered in random order. On some occasions, tests had to be administered on multiple days. The average number of days between visits was 10. Mean dBs were computed across all test locations for each subject, for each test. A 4x5 (test type, visit number) repeated measures ANOVA was performed on the averaged dBs.
Significant learning effects between visits 1 and 5 were observed for MP (1.53 dB improvement) and Matrix (.91 dB improvement) tests but not for Size III SITA or Size V (p<.001; Figure). The average learning effect between visits was only .09 dB for Size III SITA and .04 dB for Size V; whereas, for MP, the average learning effect was .38 dB and .23 for Matrix. Additionally, the largest learning effects in MP and Matrix were observed between visits 1 and 2: .86 dB improvement for MP and .42 for Matrix.
Learning effects may be minimal in glaucoma patients when they are administered multiple perimetric tests. There may be a transfer of learning effects among similar perimetric tests.
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