Agreement between 10-2 and 24-2C visual field tests for detecting glaucomatous central visual field defects

Abstract

Purpose : To assess the agreement between Humphrey Visual Field Analyzer 10-2 and 24-2C test patterns for detecting defects in the central 10 degrees of the visual field (central visual field defects, CVFDs).

Methods : In this cross-sectional study, one hundred and eight healthy, glaucoma suspect and glaucoma patients from the ongoing Diagnostic Innovations in Glaucoma Study (DIGS), who completed 10-2 and 24-2C VF testing within six months were included. 10-2 and 24-2C CVFDs were categorized into patterns of defect (including arcuate, partial arcuate, altitudinal, and widespread) by two independent graders based on total deviation (TD) and pattern deviation (PD) plots, with a consensus grade reached when there was disagreement. Cohen’s Kappa (k) statistic was used to assess agreement between 10-2 and 24-2C tests in identifying CVFDs, with bias-corrected confidence intervals determined by a clustered bootstrap procedure.

Results : The mean age of the population was 68.8 years and mean (95% CI) 10-2 mean deviation of study participants was -2.86 dB (-3.70 to -2.03). A CVFD was identified in 51 (28%) and 44 (25%) of 10-2 tests on TD and PD plots, respectively, and on 36 (20%) of 24-2C measurements (by both TD and PD criteria). Assessment of 10-2 and 24-2C tests results showed substantial agreement when identifying any CVFD with both TD (k = 0.67 [0.54-0.80]) and PD (k = 0.68 [0.54-0.79]) outside of normal limits. Similar levels of agreement were observed when identifying any superior (TD k = 0.67 [0.51-0.81], PD k = 0.62 [0.41-0.76]) or inferior CVFDs (TD k = 0.63 [0.49-0.78], PD k = 0.59 [0.40- 0.75]). Decreased agreement was observed when identifying specific patterns of CVFD.

Conclusions : The recently available 24-2C HFA 3 test pattern shows substantial agreement in assessing CVFD with 10-2 test pattern CVFD and may be considered as an alternative to 10-2 VF test for detecting central visual field defects.

This is a 2020 ARVO Annual Meeting abstract.