Diagnostic accuracy of confrontation visual field tests
- 13 April 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurology
- Vol. 74 (15), 1184-1190
- https://doi.org/10.1212/wnl.0b013e3181d90017
Abstract
Objective: To determine the diagnostic accuracy of confrontation visual field testing and to compare the accuracy of confrontation tests both individually and in combination. Methods: Patients were prospectively recruited from ophthalmology clinics over a 6-month period. All patients underwent SITA-standard 24–2 Humphrey visual field analysis. Two examiners, masked to the automated perimetry results and the results of the other examiner, assessed patients using 7 common confrontation visual field tests. The order of testing was randomized to reduce any learning effect. For each individual test and combination of tests, the sensitivity, specificity, positive predictive value, and negative predictive value were calculated. Results: A total of 301 eyes from 163 patients were included in the study. The average mean deviation was −5.91 ± 7.72 (SD) dB. Most confrontation tests were insensitive to the identification of field loss. The sensitivity and specificity varied depending on the type, density, and cause of the visual field defect. Kinetic testing with a red target provided the highest sensitivity (74.4%) and specificity (93.0%) of any individual test and when combined with static finger wiggle testing achieved a sensitivity of 78.3% while retaining a specificity of 90.1%. Conclusions: Confrontation visual field tests are insensitive at detecting visual field loss when performed individually and are therefore a poor screening test. Combining confrontation tests is a simple and practical method of improving the sensitivity of confrontation testing.This publication has 12 references indexed in Scilit:
- The essential neurologic examinationNeurology, 2009
- The quality of diagnostic accuracy studies since the STARD statementNeurology, 2006
- Classification of Visual Field Abnormalities in the Ocular Hypertension Treatment StudyAmerican Journal of Ophthalmology, 2003
- Confrontation Visual Field Loss as a Function of Decibel Sensitivity Loss on Automated Static PerimetryOphthalmology, 1995
- Detection and recognition of visual field defects resulting from lesions involving the visual pathwaysAustralian and New Zealand Journal of Ophthalmology, 1989
- Visual Field Testing With Red TargetsAmerican Journal of Ophthalmology, 1983
- Confrontation visual field techniques in the detection of anterior visual pathway lesionsAnnals of Neurology, 1981
- A Screening Method for Chiasmal Visual-Field DefectsAmerican Journal of Ophthalmology, 1981
- Automatic perimetry in glaucoma visual field screeningAlbrecht von Graefes Archiv für Ophthalmologie, 1976
- A Versatile Color Confrontation Test for the Central Visual FieldAmerican Journal of Ophthalmology, 1973