Table 1.
Full agreement (7/7) | Minimum age for starting perimetry |
Combined static and kinetic perimetry can be started in children from 7.75 years of age (IQR: 7.5–9.5) | |
Assessing perimetric test quality | |
False positives are a useful measure of test quality | |
False positive values over 15% (IQR: 12.5–20) indicate a test of poor qualitya | |
False negative values over 20% (IQR: 12.5–22.5) indicate a test of poor quality | |
Fixation losses are susceptible to artefact (such as head movement and incorrect initial plotting of the blind spot) | |
Assessing patient behaviour qualitatively (documenting co-operation, response to stimuli, fixation, and behaviour etc.) is useful for assessing perimetric test quality | |
Qualitative (examiner) comments about test quality should always be used in adjunct to quantitative measures | |
Test selection | |
In children, due to poor concentration, shorter algorithms are preferable to their longer counterparts | |
Shorter algorithms are useful to train children before undertaking longer algorithms | |
Good agreement (5/7 or 6/7) | Minimum age for starting perimetry |
Simple static or kinetic perimetry should be started from approximately 7 years of age (IQR: 6.75–7.25) | |
Assessing perimetric test quality | |
False negatives are a useful measure of test quality | |
Fixation losses are a useful measure of test quality | |
Fixation loss values over 15% (IQR: 10–22.5) indicate a test of poor quality | |
Test selection | |
Selecting a smaller test area (24°) can offer a compromise of ease, practicality, patient fatigue and information | |
The presence of moderate/severe VF loss is an indication to quantify VF extent using kinetic perimetry | |
Kinetic perimetry can be a useful adjunct to static testing in those with co-operation too poor for short static testing | |
Combining static perimetry and assessment of the far-peripheral field using kinetic perimetry is useful in assessing visual fields in children with glaucoma | |
Use of perimetry in routine clinical practice | |
Fellow eyes in unilateral glaucoma can serve as ‘controls’ within individual children, aiding monitoring of visual field progression | |
Perimetry in children should be undertaken routinely every 7.5 months (IQR: 6–11.25) | |
More frequent testing is warranted if there is suspicion of VF deterioration or poor IOP control | |
Ideally, children should be assessed with the same perimeter/algorithm throughout childhood | |
No agreement (<5/7) | Test selection |
Assessing an area of 30° is recommended | |
Assessing an area of 24° is recommended | |
Assessing progression | |
Evidence of VF progression is defined as: Loss of 2 dB (IQR: 2–2.375) mean deviation (MD) using data from at least 3 (IQR: 2.5–3) consecutive tests. | |
Use of perimetry in routine clinical practice | |
Longer algorithms (i.e., SITA Standard vs. FAST) offer greater precision in detecting progressive VF loss | |
If using shorter algorithms early in childhood (e.g., SITA FAST and G-TOP), children/young people should be switched to longer algorithms (e.g., SITA Standard and G) when appropriate |
aMissing values for one respondent.