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Br J Ophthalmol. Nov 1998; 82(11): 1236–1241.
PMCID: PMC1722423

Simulating binocular visual field status in glaucoma

Abstract

AIMS—To simulate the central binocular visual field using results from merged left and right monocular Humphrey fields. To assess the agreement between the simulation and the binocular Humphrey Esterman visual field test (EVFT).
METHOD—59 consecutive patients with bilateral glaucoma each recorded Humphrey 24-2 fields for both eyes and binocular EVFT on the same visit. EVFT results were used to identify patients exhibiting at least one defect (<10 dB) within the central 20° of the binocular field. This criterion is relevant to a patient's legal fitness to drive in the UK. Individual sensitivity values from monocular fields are merged to generate a simulated central binocular field. Results are displayed as a grey scale and as symbols representing defects at the <10 dB level. Agreement between patients failing the criterion using the simulation and the EVFT was evaluated.
RESULTS—Substantial agreement was observed between the methods in classifying patients with at least one defect (<10 dB) within the central binocular field (kappa 0.81; SE 0.09). Patients failing this criterion using the EVFT results were identified by the binocular simulation with high levels of sensitivity (100%) and specificity (86%).
CONCLUSIONS—Excellent agreement exists between the simulated binocular results and EVFT in classifying glaucomatous patients with central binocular defects. A rapid estimate of a patient's central binocular field and visual functional capacity can be ascertained without extra perimetric examination.

Keywords: glaucoma; binocular visual fields; Esterman visual field test

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
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Figures and Tables

Figure 1
Esterman visual field test output from the Humphrey visual field analyser for one of the sample patients. A circle representing the central area 20° from fixation has been superimposed. There are 24 test locations within the central area. ...
Figure 2
A schematic diagram describing the binocular simulation technique using data from the same patient shown in Figure 1. Humphrey 24-2 fields from the left and right eyes are merged point by point. The maximum sensitivity from each of the two corresponding ...
Figure 3
EVFT output for a sample patient is shown in (A). A circle has been superimposed to denote the central 20°. Results from the binocular simulation implemented by the PROGRESSOR for Windows software (Institute of Ophthalmology, London) are shown ...
Figure 4
EVFT output (A) and results from the binocular simulation (B) implemented by the PROGRESSOR for Windows software (Institute of Ophthalmology, London) are shown for another sample patient. The lower panels show the results from the binocular simulation ...

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