The SCHEIE Visual Field Grading System

Abstract

ObjectiveNo method of grading visual field (VF) defects has been widely accepted throughout the glaucoma community. The SCHEIE (Systematic Classification of Humphrey visual fields-Easy Interpretation and Evaluation) grading system for glaucomatous visual fields was created to convey qualitative and quantitative information regarding visual field defects in an objective, reproducible, and easily applicable manner for research purposes.MethodsThe SCHEIE grading system is composed of a qualitative and quantitative score. The qualitative score consists of designation in one or more of the following categories: normal, central scotoma, paracentral scotoma, paracentral crescent, temporal quadrant, nasal quadrant, peripheral arcuate defect, expansive arcuate, or altitudinal defect. The quantitative component incorporates the Humphrey visual field index (VFI), location of visual defects for superior and inferior hemifields, and blind spot involvement. Accuracy and speed at grading using the qualitative and quantitative components was calculated for non-physician graders.ResultsGraders had a median accuracy of 96.67% for their qualitative scores and a median accuracy of 98.75% for their quantitative scores. Graders took a mean of 56 seconds per visual field to assign a qualitative score and 20 seconds per visual field to assign a quantitative score.ConclusionThe SCHEIE grading system is a reproducible tool that combines qualitative and quantitative measurements to grade glaucomatous visual field defects. The system aims to standardize clinical staging and to make specific visual field defects more easily identifiable. Specific patterns of visual field loss may also be associated with genetic variants in future genetic analysis.

Topographic correlation and asymmetry analysis of ganglion cell layer thinning and the retinal nerve fiber layer with localized visual field defects

“…The mean age of the patients was 64.2 ± 12.9 years (age range: 18–88 years), and 71 patients were female (44.1%), as it is showed in Table 1 . First, we classified the damage of each hemisphere (superior and inferior) of the VF using the Scheie grading system [24]. Hence, regarding inferior VF damage, 202 (63.5%) eyes presented a normal inferior hemisphere VF (A pattern), 49 (15.4%) eyes had an F pattern of VF (early glaucoma), and 116 (36.5%) eyes had an F or worse damage of VF (G, H or I patterns; early and advanced glaucoma).…”

“…The VF was classified as normal when there was a mean deviation or a pattern standard deviation within the 95th percentile, a normal glaucoma hemifield test, and the absence of a cluster of three or more non-edge points on the pattern deviation plot with a probability of occurring in <5% of the normal population, with one of these points having the probability of occurring in <1% of the normal population. The Scheie VF grading system was used to classify and grade VF impairment as showed in Fig 3 [24]. This system must also detect small changes over time, serving as an accurate proxy of glaucoma progression [23].…”

Double Eyelid Tape as a Treatment Option for Severe Ptosis in Patients With Myotonic Dystrophy Type 1

“…1B, C). The visual field was evaluated using the Humphrey field analyzer (Carl Zeiss Meditec, Inc, Dublin, CA) and ranged from 0% (perimetrically blind) to 100% (normal) 6 . The patient showed significant postintervention improvement in the visual field area; the visual field index increased from 7% to 38% on the right and from 1% to 48% on the left (Figs.…”