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S.J. Bass, J. Cooper, J. Feldman, D. Horn; A NEW AUTOMATED CONFRONTATION TESTING DEVICE VS. FINGER COUNTING IN THE DETECTION OF FIELD LOSS IN GLAUCOMA . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4507.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the detection rate of visual field loss in glaucoma patients with established field defects using a newly designed automated confrontation visual fields testing device (ACVF) vs. standard finger counting confrontation visual field testing (FCVF). Methods: Seventy–three eyes of 45 glaucoma patients with varying stages of glaucomatous visual field loss on SITA Standard white–on–white Humphrey perimetry and 20 age–matched normals were identified. Patients were tested using standard FCVF in eight meridians in a lighted room and ACVF in a darkened room. The automated testing device consisted of a black rectangular box, 6.75" by 4.75", with four 1.0 mm red lights at each corner and a fixation hole at the center. Four automated randomized presentations were viewed and the patient was asked to identify the number of red lights seen, following a brief demonstration. A missed point on any of the four presentations on both tests was recorded as a failure. Both confrontation tests were administered at a testing distance of 2 feet. Results: All normal subjects passed both tests. Both ACVF and FCVF detected field loss in 27.4% of eyes (average MD= –22.1 dB). ACVF detected field loss in an additional 32.8% of eyes when FCVF did not (average MD= –7.0 dB), for a total detection rate of 60.2%. Both ACVF and FCVF failed to detect field loss in 39.7% of eyes tested (average MD= –5.95 dB). No patient who passed ACVF failed FCVF. The PHI square correlation was 0.06 between FCVF failure and diagnosis of glaucoma, 0.16 between ACVF failure and diagnosis of glaucoma, 0.09 between FCVF failure and field loss and 0.24 between ACVF failure and field loss. Conclusions: Gross confrontation field testing using a newly designed automated testing device had a greater rate of detection of visual field abnormalities in this small group of glaucoma patients than did finger counting and may have potential as a more accurate screening of visual field loss when routinely testing a patient in the exam chair.
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