Learning effect for frequency doubling perimetry in patients with glaucoma

Fujimoto, Naoya; Minowa, Katsuyuki; Miyauchi, Osamu; Hanawa, Tadao

doi:10.1016/s0002-9394(01)01311-3

Cited by 28 publications

(15 citation statements)

References 2 publications

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“…In this study we evaluated the learning effect for the Matrix perimetry over 5 test repetitions in patients already experienced with SAP; our results confirm previous findings suggesting that learning artefacts for FDT are mild, regardless of the version of the device, of the adopted strategy (screening [4][5][6] and full-threshold [7][8][9][10][11] procedures), and of the features of the study population (normal subjects vs. glaucomatous patients; presence or absence of previous perimetric experience).…”

Section: Discussionsupporting

confidence: 81%

“…Learning is an important factor limiting the validity of the first tests obtained with standard automated perimetry (SAP) 1 and nonconventional perimetries such as short-wavelength automated perimetry (SWAP). 2,3 On the opposite, the learning effect for both screening [4][5][6] and full-threshold [7][8][9][10][11] programs of the first generation of Humphrey Frequency Doubling Technology (FDT) perimetry has been shown to be mild and it could be minimized by previous experience with other automated perimetries.…”

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confidence: 99%

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Learning Effect of Humphrey Matrix Frequency Doubling Technology Perimetry in Patients With Ocular Hypertension

Centofanti

Fogagnolo²,

Oddone

et al. 2008

Journal of Glaucoma

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Aim: To evaluate the learning effect of Frequency Doubling Technology (FDT) perimetry using the Humphrey Matrix-FDT perimetry (Matrix) 24-2 full-threshold program on patients with ocular hypertension experienced with standard automated perimetry.Methods: Twenty-four patients with ocular hypertension underwent 5 full-threshold Matrix tests at intervals of 5 ± 2 days. Learning effect was defined as an improvement at results for duration, perimetric indices, foveal sensitivity, Glaucoma Hemifield Test, and the number of points with a P<5% and <1% in the total and pattern deviation maps. Eccentricity, hemifield, and quadrant sensitivities were also addressed as sources of differences in learning effect. Test-retest variability was also calculated for each repetition as the mean of the pointto-point interindividual standard deviations.Results: A learning effect was demonstrated for mean defect (P = 0.031, analysis of variance) and foveal sensitivity (P = 0.009) and it only affected the first test for both parameters. All the other parameters did not show any significant learning effect. The effect was independent from eccentricity and quadrant or hemifield sensitivities. Conclusions:The results of this study demonstrate that the learning effect for Matrix-FDT is mild and it may affect only the first test. Caution is needed in the analysis of the first Matrix-FDT examination and retest may be advisable in the presence of low mean defect.Key Words: frequency doubling technology, Matrix, perimetry, learning effect, ocular hypertension, glaucoma, test-retest variability (J Glaucoma 2008;17:436-441) T he improvement in perimetric results occurring over repetitions in inexperienced subjects is a well-known phenomenon called ''learning effect.'' Learning is an important factor limiting the validity of the first tests obtained with standard automated perimetry (SAP) 1 and nonconventional perimetries such as short-wavelength automated perimetry (SWAP). 2,3 On the opposite, the learning effect for both screening 4-6 and full-threshold 7-11 programs of the first generation of Humphrey Frequency Doubling Technology (FDT) perimetry has been shown to be mild and it could be minimized by previous experience with other automated perimetries.A new version of FDT perimetry, called Matrix, has been recently introduced in the clinical practice. The diagnostic performances of Matrix have been up-to-now evaluated only in a small number of clinical studies: a good correlation between results at Matrix and the Swedish Interactive Threshold Algorithm standard test (SITA-SAP) has been shown 12 and its sensitivity is probably at least similar to that of the first-generation FDT. 13 Also, a recent cross-sectional study showed that Matrix achieved the best diagnostic power for early glaucoma when compared with single morphologic tests (scanning laser polarimetry, Optical Coherence Tomography, and retinal nerve fiber layer photography). 14 Nevertheless, the limits of this perimetry have only been partially explored: in particular, its learning...

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

Learning Effect of Humphrey Matrix Frequency Doubling Technology Perimetry in Patients With Ocular Hypertension

Centofanti

Fogagnolo²,

Oddone

et al. 2008

Journal of Glaucoma

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“…Several studies showed that healthy and glaucomatous individuals can exhibit a learning effect with repeated standard automated perimetry testing (8)(9)(10)(11)(12)(13)(14)(15)(16) . This effect was also demonstrated in short wavelength automated perimetry (17)(18) , flicker perimetry (19) , and frequency doubling perimetry (20)(21)(22)(23)(24)(25) .…”

Section: Introductionmentioning

confidence: 67%

Learning effect of standard automated perimetry in healthy individuals

Castro¹,

Kawase²,

Melo³

2008

Arq. Bras. Oftalmol.

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Purpose: To evaluate the learning effect in standard automated perimetry using SITA strategy, central 24-2 program, possible associated factors and spatial distribution in individuals with no perimetry experience. Methods: A total of 55 healthy subjects were submitted to Humphrey perimetry in two different sessions in one day. Reliability and global indices, and threshold sensitivity at each point were compared between the two examinations. The influence of potential factors (age, gender, and educational level) and the spatial distribution were evaluated regarding alterations between these two examinations. Results: The duration of the test was longer in the first session (median, 5.7 min; interquartile range [IQR], 1.7 min) than in the second (median, 5.3; IQR, 1.1 min) (p=0.002). The median (IQR) of false negative errors was 2% (6%) in the first examination and 0% (6%) in the second (p=0.04). The mean (standard deviation) in the mean deviation (MD) global index was -2.31 (1.86) dB in the first examination and -1.73 (1.69) dB in the second (p=0.07). No association was observed between the change in MD and age (p=0.29), gender (p=0.69) and educational level (p=0.27). The changes in threshold sensitivity were greater at the peripheral points than at the central points (p<0.001). Conclusion: The threshold sensitivity increased in the second examination compared to the first. No factors were associated with this change. The changes in threshold sensitivity were more evident at the peripheral points. ABSTRACT INTRODUCTION

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“…For FDT too, the effect ceases or is attenuated as from the second examination [26][27][28][29][30] , although few studies have performed 1 3 examinations [31,32] . Despite the fact that our patients had previous SAP experience, we verified, with a large number of cases and examinations, that small but significant increase attributable to the learning effect may be expected beyond the third ex- amination, even with SAP.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Fluctuation of Standard Automatic Perimetry, Pulsar Perimetry and Frequency-Doubling Technology in Early Glaucoma Diagnosis

et al. 2007

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Purpose: Analyze the stability and accuracy of 3 perimetric techniques. Methods: A total of 104 stable eyes (65 subjects) with ocular hypertension and early glaucoma [group G, mean defect = 1.08 dB, SD = 2.0, in standard TOP automatic perimetry (SAP)] were examined 5 times during 18 months using: (a) SAP; (b) Pulsar temporal modulation perimetry (T30W), and (c) frequency-doubling technology (FDT N30). Ninety eyes from 90 normal controls were compared with the first set of examinations of group G. Results: The learning effect was minimal in the 3 techniques but higher in Pulsar (1.0 src, p < 0.05) than in SAP and FDT (0.4 dB). Long-term fluctuation (F) was significantly higher in FDT (3.1 dB, SD = 1.4, p < 0.0001) than in SAP (2.3 dB, SD = 1.1) and in Pulsar (1.9 src, SD = 0.7). Pulsar and FDT reduce F when increasing the number of examinations. F seems equivalent in SAP and FDT and lower in Pulsar, considering small-scale differences of the 3 perimeters. Conclusions: A slight learning effect would be expected on FDT and SAP in patients with previous experience with SAP. The stability and sensitivity of Pulsar is greater than on the other 2 systems. For early diagnosis of glaucoma it is essential to prove the reproducibility and coincidence of perimetric results.

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Learning effect for frequency doubling perimetry in patients with glaucoma

Cited by 28 publications

References 2 publications

Learning Effect of Humphrey Matrix Frequency Doubling Technology Perimetry in Patients With Ocular Hypertension

Learning Effect of Humphrey Matrix Frequency Doubling Technology Perimetry in Patients With Ocular Hypertension

Learning effect of standard automated perimetry in healthy individuals

Long-Term Fluctuation of Standard Automatic Perimetry, Pulsar Perimetry and Frequency-Doubling Technology in Early Glaucoma Diagnosis

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