Real-World Analysis of the Aging Effects on Visual Field Reliability Indices in Humans

Tomoki Shirakami,Tetsuro Omura,Masaki Tanito,Ryo Asaoka,Hiroki Fukuda

doi:10.3390/jcm10245775

Abstract

Relationships between age and visual field (VF) reliability indices were investigated using a large real-world dataset (42,421 VF data points from 11,525 eyes of 5930 subjects). All VFs tested and stored at Shimane University Hospital between 1988 and 2019 were exported. Correlations between age, mean deviation (MD), pattern standard deviation (PSD), and reliability indices including fixation losses (FLs), false negatives (FNs), and false positives (FPs) were analyzed. The mean ± standard deviation age was 65.0 ± 15.1 years; MD—−6.9 ± 8.1 decibels (dB); PSD—6.3 ± 4.6 dB; FL—8.6 ± 11.7%; FN—5.3 ± 8.3%; and FP—2.6 ± 5.0%. Univariate analyses showed strong associations between age and FNs (correlation coefficient, ρ = 0.20, p < 0.0001) and MD (ρ = −0.21, p < 0.0001). All FLs, FNs, and FPs were lowest during the third decade (20–29 years) of life. FLs were elevated consistently after that decade, and FNs were elevated sharply after the seventh decade. FPs were relatively stable after the fourth decade (30–39 years). Mixed-effect regression analyses in subjects 40 years and older showed that older age was associated with worse FLs (p < 0.0001) and FNs (p < 0.0001) but not FPs (p = 0.4126). Aging affects FLs and FNs with different modes but had minimal effects on FPs. Decreased VF sensitivity, deteriorated macular function, and technical difficulties with testing may be mechanisms of age-related changes in FLs and FNs.

Highlights

The use of semiautomated perimeters in ophthalmology is essential, especially in the management of patients with glaucoma
We investigated the relationship between age and reliability indices such as fixation losses (FLs), false negatives (FNs), and false positive (FPs) from a large dataset of perimetry tests
FLs were elevated consistently after the third decade of life, and FNs were elevated sharply after the seventh decade of life, while FPs were relatively stable after the fourth decade of life (Figure 2)

Summary

Introduction

The use of semiautomated perimeters in ophthalmology is essential, especially in the management of patients with glaucoma. Retinal function is assessed by determining light sensitivity thresholds using static perimetry methods. A few studies have indicated other patient-related factors associated with VF fluctuation, including visual acuity [7], ethnicity [8], and cognitive decline [9]. Jaffe et al reported that age-related decline in threshold sensitivity and the standard error of the decline increased with fixation eccentricity [10]. The normal standards published for OCTOPUS perimetry include adjustments derived from a measured linear decline in light sensitivity as an aging function [10]. We investigated the relationship between age and reliability indices such as fixation losses (FLs), false negatives (FNs), and false positive (FPs) from a large dataset of perimetry tests

Methods

Results

Discussion

Conclusion