This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (27)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Immunology  • Immunologic Disorders  • Alert me on articles by topic

Michael Wall, MD; Chris A. Johnson, PhD; Kim E. Kutzko; Richard Nguyen, MD; Caridad Brito, PhD; John L. Keltner, MD

Arch Ophthalmol. 1998;116:53-61.

Objective  To measure the short- and long-term variability of automated perimetry in patients with optic neuritis and normal subjects.

Design  Prospective case-control design of patients with recovered optic neuritis with intraday and interday repetitions to obtain robust variability measurements. Entry criteria included a corrected pattern SD that was worse than the normal 5% probability level and a mean deviation worse than -3 dB but better than -20 dB. Five Humphrey 30-2 full threshold tests were administered during a 7-hour period (1 test every 2 hours) on the same day and at the same periods on 5 separate days.

Subjects  Seventeen patients with recovered optic neuritis and 10 healthy subjects of similar age.

Main Outcome Measures  Short-term variability and long-term variability for global visual field data.

Results  Patients with optic neuritis demonstrated variations in visual field sensitivity that were outside the entire range of variability for normal controls. These variations occurred for multiple tests performed on the same day at specific times and for tests performed at specific times on different days. There were no consistent patterns of sensitivity changes that could be attributed to time of day. The most dramatic fluctuations occurred in a patient whose visual fields varied from normal to a hemianopic defect from one week to another and from a partial quadrant loss to a hemianopic defect at different times on the same day. Seven of the patients with optic neuritis also demonstrated intermittent vertical step defects.

Conclusions  Patients with resolved optic neuritis can have large variations in visual field results on different days and at different times on the same day. The variations affect both the severity and the pattern of visual field loss and do not appear to be consistent across patients. These data indicate that care must be taken when automated visual field results in patients with optic neuritis are interpreted. Distinguishing systematic changes in sensitivity from variability requires more than a comparison of the current visual field with the most recent previous visual field.

From the Departments of Neurology and Ophthalmology, Veterans Affairs Hospital and University of Iowa College of Medicine, Iowa City (Drs Wall and Brito and Ms Kutzko), and Optics and Visual Assessment Laboratory and Departments of Ophthalmology (Drs Johnson, Nguyen, and Keltner), Neurology (Dr Keltner), and Neurological Surgery (Dr Keltner), University of California, Davis School of Medicine. Ms Kutzko is now with the Department of Epidemiology, University of Michigan, Ann Arbor.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Relationship between Visual Field and Retinal Nerve Fiber Layer Measurements in Patients with Multiple Sclerosis
Cheng et al.
IOVS 2007;48:5798-5805.
ABSTRACT | FULL TEXT  

Automated Combined Kinetic and Static Perimetry: An Alternative to Standard Perimetry in Patients With Neuro-ophthalmic Disease and Glaucoma.
Pineles et al.
Arch Ophthalmol 2006;124:363-369.
ABSTRACT | FULL TEXT  

Measurement error of visual field tests in glaucoma
Spry et al.
Br. J. Ophthalmol. 2003;87:107-112.
ABSTRACT | FULL TEXT  

A randomized trial of intravenous immunoglobulin in inflammatory demyelinating optic neuritis
Noseworthy et al.
Neurology 2001;56:1514-1522.
ABSTRACT | FULL TEXT  

Variability Components of Standard Automated Perimetry and Frequency-Doubling Technology Perimetry
Spry et al.
IOVS 2001;42:1404-1410.
ABSTRACT | FULL TEXT  

SITA Standard in Optic Neuropathies and Hemianopias: A Comparison with Full Threshold Testing
Wall et al.
IOVS 2001;42:528-537.
ABSTRACT | FULL TEXT  

Confirmation of Visual Field Abnormalities in the Ocular Hypertension Treatment Study
Keltner et al.
Arch Ophthalmol 2000;118:1187-1194.
ABSTRACT | FULL TEXT  

Response Variability in the Visual Field: Comparison of Optic Neuritis, Glaucoma, Ocular Hypertension, and Normal Eyes
Henson et al.
IOVS 2000;41:417-421.
ABSTRACT | FULL TEXT