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False Positive Responses in Standard Automated Perimetry

Heijl, Anders LU ; Patella, Vincent Michael ; Flanagan, John G. ; Iwase, Aiko ; Leung, Christopher K. ; Tuulonen, Anja ; Lee, Gary C. ; Callan, Thomas and Bengtsson, Boel LU (2022) In American Journal of Ophthalmology 233. p.180-188
Abstract

Purpose: To analyze the relationship between rates of false positive (FP) responses and standard automated perimetry results. Design: Prospective multicenter cross-sectional study. Methods: One hundred twenty-six patients with manifest or suspect glaucoma were tested with Swedish Interactive Thresholding Algorithm (SITA) Standard, SITA Fast, and SITA Faster at each of 2 visits. We calculated intervisit 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 3 algorithms, but the effects were small, 0.3 dB to 0.6 dB, for an increase... (More)

Purpose: To analyze the relationship between rates of false positive (FP) responses and standard automated perimetry results. Design: Prospective multicenter cross-sectional study. Methods: One hundred twenty-six patients with manifest or suspect glaucoma were tested with Swedish Interactive Thresholding Algorithm (SITA) Standard, SITA Fast, and SITA Faster at each of 2 visits. We calculated intervisit 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 3 algorithms, but the effects were small, 0.3 dB to 0.6 dB, for an increase of 10 percentage points of FP rate, and for VFI even smaller (0.6%-1.4%). Only small parts of intervisit 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 dB to 2.0 dB per 10 percentage points of FP, and r2 values ranging from 0.04 to 0.33. The 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. Conclusions: Across 3 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 having perceived stimuli.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
False positive responses, Glaucoma, Perimetry, Reliability Parameters, Standard Automated Perimetry, Visual Field Testing
in
American Journal of Ophthalmology
volume
233
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:85118803594
  • pmid:34283973
ISSN
0002-9394
DOI
10.1016/j.ajo.2021.06.026
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Author(s)
id
f0d757ef-be26-41a4-9edd-2e14333face7
date added to LUP
2021-12-02 16:39:30
date last changed
2024-02-20 18:25:23
@article{f0d757ef-be26-41a4-9edd-2e14333face7,
  abstract     = {{<p>Purpose: To analyze the relationship between rates of false positive (FP) responses and standard automated perimetry results. Design: Prospective multicenter cross-sectional study. Methods: One hundred twenty-six patients with manifest or suspect glaucoma were tested with Swedish Interactive Thresholding Algorithm (SITA) Standard, SITA Fast, and SITA Faster at each of 2 visits. We calculated intervisit 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 3 algorithms, but the effects were small, 0.3 dB to 0.6 dB, for an increase of 10 percentage points of FP rate, and for VFI even smaller (0.6%-1.4%). Only small parts of intervisit differences were explained by FP (r<sup>2</sup> values 0.00-0.11). The effects of FP were larger in severe glaucoma, with MD increases of 1.1 dB to 2.0 dB per 10 percentage points of FP, and r<sup>2</sup> values ranging from 0.04 to 0.33. The 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. Conclusions: Across 3 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 having perceived stimuli.</p>}},
  author       = {{Heijl, Anders and Patella, Vincent Michael and Flanagan, John G. and Iwase, Aiko and Leung, Christopher K. and Tuulonen, Anja and Lee, Gary C. and Callan, Thomas and Bengtsson, Boel}},
  issn         = {{0002-9394}},
  keywords     = {{False positive responses; Glaucoma; Perimetry; Reliability Parameters; Standard Automated Perimetry; Visual Field Testing}},
  language     = {{eng}},
  pages        = {{180--188}},
  publisher    = {{Elsevier}},
  series       = {{American Journal of Ophthalmology}},
  title        = {{False Positive Responses in Standard Automated Perimetry}},
  url          = {{http://dx.doi.org/10.1016/j.ajo.2021.06.026}},
  doi          = {{10.1016/j.ajo.2021.06.026}},
  volume       = {{233}},
  year         = {{2022}},
}