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A.S. Collins, S.A. Newman, M.L. Deihl; Validation of the Glaucoma Hemifield Test for AION . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1958.
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Purpose: The glaucoma hemifield test (GHT) is designed to detect subtle arcuate visual field defects in patients with glaucomatous optic neuropathy. We attempted to determine if this test could also be applied to anterior ischemic optic neuropathy. Methods: Four hundred eighty three 24-2 visual fields of 181 patients from the UVA Eye Center coded with the clinical diagnosis of AION were evaluated for test strategy, foveal sensitivity, reliability coefficients, and glaucoma hemifield test score. Visual fields with greater than 33% false positive or false negative responses were excluded, leaving us with 448 visual fields of 146 patients (90 female, 56 male). Of these, three hundred ninety eight fields were performed with full threshold strategy, 19 with SITA standard and 31 with SITA fast. Right eyes accounted for 236 fields (53%) and left eyes for 212 (47%). Results: In our patient group, the glaucoma hemifield test was reported as Within Normal Limits in 22 of 448 visual fields (5%), Borderline in 14 fields (3%), Outside Normal Limits in 403 fields (90%), and as Generalized Reduction in Sensitivity in 9 fields (2%). Conclusions: The GHT was not Outside Normal Limits in 10% of fields of patients with AION. This may be due to decreased acuity related to relative involvement of the papillomacular bundle giving central scotomas. The high frequency of abnormal GHT in AION patients indicates the nonspecific sensitivity of this test in other (nonglaucomatous) forms of optic nerve pathology.
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