The Frontloading Fields Study: The Impact of False Positives and Seeding Point Errors on Visual Field Reliability When Using SITA-Faster

• Published in: Translational vision science & technology Vol. 11; no. 2; p. 20
• Main Authors: Phu, Jack, Kalloniatis, Michael
• Format: Journal Article
• Language: English
• Published: United States The Association for Research in Vision and Ophthalmology 01.02.2022
• Subjects: Glaucoma - diagnosis; Humans; Intraocular Pressure; Reproducibility of Results; Vision Disorders; Visual Field Tests - methods; Visual Fields
• ISSN: 2164-2591; 2164-2591
• DOI: 10.1167/tvst.11.2.20

The purpose of this study was to evaluate the impact of two conventional reliability criteria (false positives [FPs] and seeding point errors [SPEs]) and the concurrent effect of low sensitivity points (≤19 dB) on intrasession SITA-Faster visual field (VF) result correlations. There were 2320 intrasession SITA-Faster VF results from 1160 eyes of healthy, glaucoma suspects, and subjects with glaucoma that were separated into "both reliable" or "reliable-unreliable" pairs. VF results (mean deviation and pointwise sensitivity) were analyzed against the spectrum of FP rates and SPE, with and without censorship of sensitivity results ≤19 dB. Segmental linear regression was used to identify critical points where visual field results were significantly different between tests due to FP levels. There was a significant, but small (0.09 dB per 1% exceeding 12%) increase in mean deviation, and an increase in the number of points showing a >3 dB sensitivity increase (0.25-0.28 locations per 1% exceeding 12%). SPEs were almost exclusively related to a decrease in sensitivity at the primary seeding points but did not result in significant differences in other indices. Censoring sensitivity results ≤19 dB significantly improved the correlation between reliable and unreliable results. Current criteria for judging an unreliable VF result (FP rate >15% and SPE) can lead to data being erroneously excluded, as many results do not show significant differences compared to those deemed "reliable." Censoring of sensitivity results ≤19 dB improves intrasession correlations in VF results. We provide guidelines for assessing the impact of FP, SPE, and low sensitivity results on VF interpretation.