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. 2017 Jun;8(3):651.
doi: 10.4172/2155-9570.1000651. Epub 2017 May 11.

The SCHEIE Visual Field Grading System

Prithvi S Sankar  1 , Laura O'Keefe  1 , Daniel Choi  1 , Rebecca Salowe  1 , Eydie Miller-Ellis  1 , Amanda Lehman  1 , Victoria Addis  1 , Meera Ramakrishnan  1 , Vikas Natesh  1 , Gideon Whitehead  1 , Naira Khachatryan  1 , Joan O'Brien  1
Affiliations

The SCHEIE Visual Field Grading System

Prithvi S Sankar et al. J Clin Exp Ophthalmol. 2017 Jun.

Abstract

Objective: No method of grading visual field (VF) defects has been widely accepted throughout the glaucoma community. The SCHEIE (Systematic Classification of Humphrey visual fields-Easy Interpretation and Evaluation) grading system for glaucomatous visual fields was created to convey qualitative and quantitative information regarding visual field defects in an objective, reproducible, and easily applicable manner for research purposes.

Methods: The SCHEIE grading system is composed of a qualitative and quantitative score. The qualitative score consists of designation in one or more of the following categories: normal, central scotoma, paracentral scotoma, paracentral crescent, temporal quadrant, nasal quadrant, peripheral arcuate defect, expansive arcuate, or altitudinal defect. The quantitative component incorporates the Humphrey visual field index (VFI), location of visual defects for superior and inferior hemifields, and blind spot involvement. Accuracy and speed at grading using the qualitative and quantitative components was calculated for non-physician graders.

Results: Graders had a median accuracy of 96.67% for their qualitative scores and a median accuracy of 98.75% for their quantitative scores. Graders took a mean of 56 seconds per visual field to assign a qualitative score and 20 seconds per visual field to assign a quantitative score.

Conclusion: The SCHEIE grading system is a reproducible tool that combines qualitative and quantitative measurements to grade glaucomatous visual field defects. The system aims to standardize clinical staging and to make specific visual field defects more easily identifiable. Specific patterns of visual field loss may also be associated with genetic variants in future genetic analysis.

Keywords: Glaucoma; Glaucomatous visual fields; Open-angle glaucoma; Standard automated perimetry; Visual field defects; Visual field grading; Visual fields.

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Figures

Figure 1
Figure 1
Nine Categories for Qualitative Grade: Normal (A), Central Scotoma (B), Paracentral Scotoma (C), Paracentral Crescent (D), Temporal Quadrant (E), Nasal Quadrant (F), Peripheral Arcuate (G), Expansive Arcuate (H), Altitudinal Defect (I). Note: Defects are only shown in the superior hemifield.
Figure 2
Figure 2
Illustration of Points within 5° (blue), within 10° (red/orange), and Adjacent to Blind Spot (yellow/orange).
Figure 3
Figure 3
Four Examples of Grading System (A, B, C, D). The defects are highlighted (qualitative grade) and outlined (hemifield portion of quantitative grade).
See this image and copyright information in PMC

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