Researchers recently compared the variability and ability to detect visual field (VF) progression of the 24-2, central 24-2 and 10-2 tests in eyes with abnormal VFs. The team determined that the time to detect central VF progression was reduced with 10-2 mean deviation (MD) due to the test’s lower variability.1
“Identifying glaucoma progression perimetrically can be challenging due to variability in testing and patient responses,” noted Joseph Sowka, an attending optometric physician at Center for Sight in Sarasota, FL, in his commentary of the study on Practice Update. “Additionally, the most used perimetric program in glaucoma, the 24-2 pattern, can miss small changes due to the degree of spacing of tested points.”2
The study included a total of 52,806 24-2 and 11,966 10-2 VF tests from 7,307 eyes from the Glaucoma Research Network database. Only eyes with five or more visits and two or more years of follow-up were included.1
Upon evaluating all three patterns, MD variability was highest within the -5dB to -20dB range and consistently lower with the 10-2 compared with the 24-2 and central 24-2. Overall, time to detect confirmed significant progression at 80% power was the lowest with the 10-2 test, with a decrease of 14.6% to 18.5% when compared with the 24-2 and a decrease of 22.9% to 26.5% when compared with the central 24-2.1
The researchers believe these findings contribute to current evidence of the potential value of 10-2 testing in glaucoma patient management and in clinical trial design. Using 10-2 tests could result in a moderate increase in the ability to detect progression centrally, without compromising the clinician’s assessment of non-central regions.1
“As our understanding of the macular structural changes and central functional loss previously not recognized in glaucoma increases, it seems that central 10-2 visual field testing should become more routine,” Dr. Sowka commented.2
1. Susanna FN, Melchior B, Paula JS, et al. Variability and power to detect progression of different visual field patterns. Ophthalmology. April 20, 2021. [Epub ahead of print].
2. Freeman KF, Sowka J. Progression detection with different visual field patterns. Practice Update. www.practiceupdate.com/c/117552/2/5. May 10, 2021. Accessed May 19, 2021.