False Positive Responses in Standard Automated Perimetry
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersPURPOSE
To analyze the relationship between rates of false positive (FP) responses and standard automated perimetry results.
DESIGN
Prospective multicenter cross-sectional study.
METHODS
126 patients with manifest or suspect glaucoma were tested with SITA Standard, SITA Fast and SITA Faster at each of two visits. We calculated inter-visit differences in mean deviation (MD), visual field index (VFI) and number of statistically significant test points as a function of FP rates and also as a function of general height (GH).
RESULTS
Increasing FP values were associated with higher MD values for all three algorithms, but the effects were small, 0.3-0.6 dB, for an increase of 10 percentage points of FP rate, and for VFI even smaller, 0.6-1.4%. Only very small parts of inter-visit differences were explained by FP (r2-values 0.00-0.11). The effects of FP were larger in severe glaucoma, with MD increases of 1.1-2.0 dB per 10 percentage points of FP, and r2 values ranging from 0.04 to 0.33. Numbers of significantly depressed total deviation points were affected only slightly, and pattern deviation probability maps were generally unaffected. GH was much more strongly related to perimetric outcomes than FP was.
CONCLUSIONS
Across three different standard automated perimetry thresholding algorithms, FP rates showed only weak associations with visual field test results, except in severe glaucoma. Current recommendations regarding acceptable FP ranges may require revision. GH or other analyses may be better suited than FP rates for identifying unreliable results in patients who frequently press the response button without actually having perceived stimuli.
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Additional Info
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False Positive Responses in Standard Automated Perimetry
Am J Ophthalmol 2021 Jul 17;[EPub Ahead of Print], H Anders, P Vincent Michael, F John G, I Aiko, L Christopher K, T Anja, L Gary C, C Thomas, B BoelFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The authors evaluated data from 126 patients with manifest or suspected glaucoma based on visual field testing using SITA Standard, SITA Fast and SITA Faster at each of two visits in order to determine "the relationship between rates of false-positive (FP) responses and standard automated perimetry results." The authors conclude, "Across 3 different standard automated perimetry thresholding algorithms, FP rates showed only weak associations with visual field test results, except in severe glaucoma." They also suggest that some standards may need to be revised as may the criteria for unreliability. A good summary statement from the authors is the following: "...it seems likely that test results should never be discarded solely on the basis of FP response rates." Possible reasons for differences among specific test strategies are discussed. Good to know.