Study of Optimal Perimetric Testing In Children (OPTIC)

Patel, Dipesh; Cumberland, Phillippa; Walters, Brandon J.; Russell‐Eggitt, Isabelle; Cortina‐Borja, Mario; Rahi, Jugnoo S

doi:10.1016/j.ophtha.2015.04.038

Cited by 40 publications

(48 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Children exhibited a level of interobserver variability similar to adults (SD ¼ 1.5 dB vs. 1.4 dB in adults), and the 1.9-dB deficit is consistent with previous data from ordinary static threshold perimetry. For example, Patel and colleagues 34 reported a 1.85-dB deficit among 9-to 11-year-olds (grid ¼ 6248), while Tschopp and colleagues 35 reported a~1-dB deficit in 7-and 8-year-olds (grid ¼ 638).…”

Section: Sensitivitymentioning

confidence: 99%

Feasibility of Macular Integrity Assessment (MAIA) Microperimetry in Children: Sensitivity, Reliability, and Fixation Stability in Healthy Observers

Jones

Yasoubi

Nardini

et al. 2016

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

PURPOSE.To assess the feasibility of macular integrity assessment (MAIA) microperimetry (MP) in children. Also to establish representative outcome measures (differential light sensitivity, fixation stability, test-retest reliability) for children without visual impairment.METHODS. Thirty-three adults and 33 children (9-12 years) were asked to perform three monocular MAIA examinations within a single session (dominant eye only). RESULTS.Children exhibited poorer test-retest reliability than adults for measures of both mean sensitivity (95% coefficient of repeatability [CoR 95 ] ¼ 2.7 vs. 2.3 dB, P ¼ 0.036) and pointwise sensitivity (CoR 95 ¼ 6.2 vs. 5.7 dB, P < 0.001). Mean sensitivity was lower in children (27.6 vs. 29.5 dB, P < 0.001), and fixation stability was poorer (95% bivariate contour ellipse area [BCEA 95 ] ¼ 4.58 vs. 1.14, P < 0.001). Mean sensitivity was negatively correlated with fixation stability (r ¼ À0.44, P < 0.001). Both children and adults exhibited substantial practice effects, with mean sensitivity improving by 0.5 dB (adults) and 0.9 dB (children) between examinations 1 and 2 (P 0.017). There were no significant differences between examinations 2 and 3 (P ‡ 0.374).CONCLUSIONS. Microperimetry is feasible in 9-to 12-year-old children. However, systematically lower sensitivities mean that the classification boundary for ''healthy'' performance should be lowered in children, pending development of techniques to improve attentiveness/fixation that may reduce or remove this difference. High measurement variability suggests that the results of multiple tests should be averaged when possible. Learning effects are a potential confound, and it is recommended that the results of the first examination be discarded.

show abstract

Section: Sensitivitymentioning

confidence: 99%

Feasibility of Macular Integrity Assessment (MAIA) Microperimetry in Children: Sensitivity, Reliability, and Fixation Stability in Healthy Observers

Jones

Yasoubi

Nardini

et al. 2016

Invest. Ophthalmol. Vis. Sci.

View full text Add to dashboard Cite

show abstract

“…46,54 Contrary to previously reported studies, 44,45 a reduction in sensitivity with age was not observed. Adult-like sensitivity values, 46,54 range 19 to 38 dB, were observed in 7- and 8-year-old subjects.…”

Section: Discussionmentioning

confidence: 80%

“…However, our test completion success rate was similar to previous studies involving conventional strategies and a pediatric population. 44,45 During our clinical evaluation work, a smaller number of presentations were performed for a comparable test time to that presented in the literature. 46–49 The long test duration to stimuli presentation ratio is a consequence of the game strategy used, and resulted from a longer than average interstimuli interval.…”

Section: Discussionmentioning

confidence: 99%

Development of a Pediatric Visual Field Test

Miranda

Henson

Fenerty

et al. 2016

Trans. Vis. Sci. Tech.

View full text Add to dashboard Cite

PurposeWe describe a pediatric visual field (VF) test based on a computer game where software and hardware combine to provide an enjoyable test experience.MethodsThe test software consists of a platform-based computer game presented to the central VF. A storyline was created around the game as was a structure surrounding the computer monitor to enhance patients' experience. The patient is asked to help the central character collect magic coins (stimuli). To collect these coins a series of obstacles need to be overcome. The test was presented on a Sony PVM-2541A monitor calibrated from a central midpoint with a Minolta CS-100 photometer placed at 50 cm. Measurements were performed at 15 locations on the screen and the contrast calculated. Retinal sensitivity was determined by modulating stimulus in size. To test the feasibility of the novel approach 20 patients (4–16 years old) with no history of VF defects were recruited.ResultsFor the 14 subjects completing the study, 31 ± 15 data points were collected on 1 eye of each patient. Mean background luminance and stimulus contrast were 9.9 ± 0.3 cd/m2 and 27.9 ± 0.1 dB, respectively. Sensitivity values obtained were similar to an adult population but variability was considerably higher – 8.3 ± 9.0 dB.ConclusionsPreliminary data show the feasibility of a game-based VF test for pediatric use. Although the test was well accepted by the target population, test variability remained very high.Translational RelevanceTraditional VF tests are not well tolerated by children. This study describes a child-friendly approach to test visual fields in the targeted population.

show abstract

“…Non-seeing isopters were assigned negative area values in this study. It should be noted that in some previous publications, isopter groups have been referred to as isopters; 14,20,23,27,30–32,37 the two terms should not be confused.…”

Section: Methodsmentioning

confidence: 99%

“…Popular methods include the use of software that can analyze scanned images of GVFs (e.g. Adobe Photoshop, 23,34,37 Engauge Digitizer, 32 GIMP, 27 JHU’s FieldDigitize, 7,10,24 MathWorks MATLAB, 14 NIH’s ImageJ, 18,31 Scion Image, 34,36 UCL’s Retinal Area Analysis Tool, 28 UTHSCSA ImageTool 29,33 ), or handheld devices to convey position information to computer software. 5,20,21,23,26 To our knowledge, however, none of these previous studies have explored the variability of calculated retinal areas or the error rates of digitizers.…”

mentioning

confidence: 99%

Variability and Errors of Manually Digitized Goldmann Visual Fields

et al. 2016

View full text Add to dashboard Cite

Purpose Goldmann visual fields (GVFs) are useful for tracking changes in areas of functional retina, including the periphery, in inherited retinal degeneration patients. Quantitative GVF analysis requires digitization of the chart coordinates for the main axes and isopter points marked by the GVF operator during testing. This study investigated inter- and intra-digitizer variability among users of a manual GVF digitization program. Methods Ten digitizers were trained for one hour, then digitized 23 different GVFs from inherited retinal degeneration patients in each of three testing blocks. Digitizers labeled each isopter as seeing or non-seeing, and its target size. Isopters with the same test target within each GVF were grouped to create isopter groups. Results The standard deviation of isopter group area showed an approximate square-root relationship with total isopter group area. Accordingly, the coefficient of variation for isopter group area decreased from 68% to 0.2% with increasing isopter group area. A bootstrap version of ANOVA did not reveal a significant effect of digitizers on isopter group area. Simulations involving random sampling of digitizers showed that 5–7 digitizers would be required to catch 95–99% of labeling errors and isopter misses, on the basis of data discrepancies, with 99% probability. Conclusions These data suggest that any minimally trained digitizer would be capable of reliably determining any isopter area, regardless of size. Studies using this software could either use 5–7 minimally trained digitizers for each GVF, three digitizers who demonstrate low frequencies of errors on a practice set of GVFs, or two digitizers with an expert reader to adjudicate discrepancies and catch errors.

show abstract

Study of Optimal Perimetric Testing In Children (OPTIC)

Abstract: Visual field size and sensitivity increase with age in patterns that are specific to the perimetric approach used. These developmental changes should be accounted for when interpreting perimetric test results in children, particularly when monitoring change over time.

Cited by 40 publications

References 15 publications

Feasibility of Macular Integrity Assessment (MAIA) Microperimetry in Children: Sensitivity, Reliability, and Fixation Stability in Healthy Observers

Feasibility of Macular Integrity Assessment (MAIA) Microperimetry in Children: Sensitivity, Reliability, and Fixation Stability in Healthy Observers

Development of a Pediatric Visual Field Test

Variability and Errors of Manually Digitized Goldmann Visual Fields

Contact Info

Product

Resources

About