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Review
. 2008 Apr;92(4):569-73.
doi: 10.1136/bjo.2007.135012. Epub 2008 Jan 22.

Practical recommendations for measuring rates of visual field change in glaucoma

B C Chauhan  1 , D F Garway-Heath, F J Goñi, L Rossetti, B Bengtsson, A C Viswanathan, A Heijl
Affiliations
Review

Practical recommendations for measuring rates of visual field change in glaucoma

B C Chauhan et al. Br J Ophthalmol. 2008 Apr.

Abstract

To date, there has been a lack of evidence-based guidance on the frequency of visual field examinations required to identify clinically meaningful rates of change in glaucoma. The objective of this perspective is to provide practical recommendations for this purpose. The primary emphasis is on the period of time and number of examinations required to measure various rates of change in mean deviation (MD) with adequate statistical power. Empirical data were used to obtain variability estimates of MD while statistical modelling techniques derived the required time periods to detect change with various degrees of visual field variability. We provide the frequency of examinations per year required to detect different amounts of change in 2, 3 and 5 years. For instance, three examinations per year are required to identify an overall change in MD of 4 dB over 2 years in a patient with average visual field variability. Recommendations on other issues such as examination type, strategy and quality are also made.

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Conflict of interest statement

Competing interests: BCC is or has been a consultant for Allergan, Mimetogen, Pfizer and QLT, and has received research support from Alcon, Carl Zeiss Meditec, Heidelberg Engineering, Pfizer and Welch Allyn. DFGH is or has been a consultant for Allergan, Carl Zeiss Meditec and Pfizer, and has received research support from Allergan, Carl Zeiss Meditech, Heidelberg Engineering, Optovue, Pfizer, Reichert and Santen. FJG has been reimbursed by Alcon, Allergan, Carl Zeiss Meditec and Pfizer for attending conferences and running educational programmes. BB is a consultant for Carl Zeiss Meditec and received travel support from Allergan and research funding from Carl Zeiss Meditec. ACV has been a consultant, received honoraria or teaching funding from Alcon, Allergan, Merck Sharpe Dohme and Pfizer, and is a developer of PROGRESSOR, a commercially available software package for visual field analysis. AH is or has been a consultant for Alcon Allergan, Carl Zeiss Meditec and Pfizer, and has received research support from Alcon, Allergan, Carl Zeiss Meditec and Santen.

Figures

Figure 1
Figure 1. Distribution of intra-individual standard deviation (SD) of MD values in patients followed for up to 12 years.
Figure 2
Figure 2. Statistical power to detect a significant rate of change of MD expressed as a function of variability (SD of the MD values) and number of examinations.
See this image and copyright information in PMC

Comment in

References

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