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BACKGROUND: Frequency doubling perimetry (FDP) shows good correlation with achromatic automated perimetry in the assessment of glaucoma. However, many recommended protocols lead to a significant number of false positives and negatives. Therefore, it may be difficult to identify visual field loss owing to glaucoma. We investigated the accuracy of a diagnostic protocol that only considered either temporal wedge, arcuate, or nasal step field loss on an FDP field as significant. METHODS: Sixty-eight subjects who were glaucoma suspects, glaucoma patients or normal controls were recruited selectively. After achromatic automated perimetry and FDP visual field testing, results were compared between a conventional protocol and ones that took into account the position of FDP visual field loss. RESULTS: If an FDP field was considered abnormal only when either a temporal wedge, an arcuate or a nasal step defect was present, the presence of a nasal step yielded the most accurate results with the least false positives (κ coefficient = 0.76) and with only minimal increase in false negatives, compared with a conventional FDP protocol (κ coefficient = 0.70). CONCLUSIONS: Although not statistically significant in this case, our results suggested a trend that a diagnostic protocol which considers nasal step FDP field loss significant may have a greater degree of accuracy when compared with conventional protocols and may facilitate interpretation in a clinical setting.
Dr. J. Landers, Eye Associates, Park House, Macquarie St, Adelaide, South Australia, Australia. john.landers@bigpond.com
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)