Specificity of various cluster criteria used for the detection of glaucomatous visual field abnormalities.

PURPOSE: This study aimed to evaluate the specificity of commonly used cluster criteria for defining the presence of glaucomatous visual field abnormalities and the impact of variations in the criterion used. METHODS: This is an observational study including 607 eyes from 384 healthy participants, and 501 eyes of 345 participants with glaucoma, with at least two reliable 24-2 visual field tests. An abnormal visual field cluster was defined as the presence of ≥3 contiguous abnormal locations. Variations in this definition were evaluated and included (1) whether abnormalities were based on total deviation and/or pattern deviation values; (2) probability cut-off for defining an abnormal location; and (3) whether abnormalities were required to be repeatable (within the same hemifield or at the same locations) or not. These definitions were also compared against pattern standard deviation (PSD) values. RESULTS: False-positive rates of various cluster criteria ranged between 9% and 46% depending on the specific definitions used. Only definitions that required abnormalities to be repeatable at the same location achieved a false-positive rate of ≤6%. The various cluster criteria generally performed similarly or worse at detecting glaucoma eyes compared with the PSD values. CONCLUSIONS: Commonly used visual field cluster criteria have high false-positive rates that vary widely depending on the definition used. These findings highlight the need to carefully consider the criteria used when designing and interpreting glaucoma clinical studies. TRIAL REGISTRATION NUMBER: NCT00221923.

Duke Scholars

Author Felipe Medeiros Ophthalmology, Glaucoma