Properties of the Statpac Visual Field Index (VFI)

Paul H Artes & Balwantray C Chauhan, Ophthalmology and Visual Sciences, Dalhousie University, Halifax, N.S., Canada
Fig 4) total- & pattern

MD VFI
deviation
100 Selected examples of change over time with MD
Purpose (left) and VFI (right). Both indices are plotted
against age. The lines are from linear regression,
dB %

To compare the statistical properties of the visual field index (VFI) to 90 and a star (*) indicates p < 0.01 with a negative

Visual Field Index (%)

slope.
those of Mean Deviation (MD), in patients with glaucoma followed 80
Total- & pattern deviation probability and greyscale
over time. maps of three selected tests are shown on the right.

Methods
70 These are the first and last test of the series, and
     
    the one closest to the midpoint of the follow-up.

  
 
     
   
60   

MD and VFI were calculated for visual fields from 109 patients
    


   
   
In #1 and 2, there is substantive agreement
 
   
     

    
between MD and VFI. Visual field progression is
followed for 10 years (median, 22 tests). Variability, rates of change, 50  
 
  

   
  


often non-linear, and we did not find evidence for


their statistical significance, and evidence for non-linearity in


 


differences in the quality of fit of the linear trend total- & pattern

 
(#2). #3 shows early and mainly diffuse change

MD VFI
progression were compared between the indices. 40 


that is de-emphasized with the VFI (although both

deviation


indices show a significant trend). The patient in #4 dB %
    

Results
30  is a poor test taker who continued to improves over
several years. Despite the development of deep
-25 -20 -15 -10 -5 0 5 paracentral loss threatening fixation, the MD (but
not the VFI) improved over time.
The relationship between the MD and VFI (r=0.83, p<0.001)
Mean Deviation (dB)
appeared linear, except with MDs better than -5.0 dB where 7/132 
Fig 1) Visual Field Index (VFI, %) and Mean Deviation (dB).
eyes (5.3%) had a VFI of 100% (ceiling effect, Fig 1). The predicted The relationship between both indices was estimated with a robust 

VFIs for fields with MD values of 0 dB, -10 dB, and -15 dB were nonparametric regression (Loess, red line). A ceiling effect is noticeable

 
 with MDs better than -5 dB (see inset for greater detail).
100%, 77%, and 63%, respectively. Rates of change of the two 

indices were also closely related (r=0.75, p<0.001), and statistically total- & pattern
deviation

significant trends over time (p<0.05) occurred in the same number 

dB %
 
of eyes (87/204, 43%). Of the 104 eyes with significant trend on
 

 
either VFI or MD, 70 eyes showed trends in both indices (kappa, 

0.66). The variability over time of the VFI was more closely related    
slope of VFI (%/y)


MD VFI
      
to visual field damage than that of the MD (Spearman r, -0.86 and 

-0.59, Fig 3), and there was no evidence that change over time
was more linear with the VFI than the MD (pairwise comparison   


of Durbin-Watson statistics, Wilcoxon test, p=0.67). 


 

 
  

 total- & pattern

Conclusions 
deviation

 
dB %

 
The VFI provides a simple and intuitive metric of visual field 
damage. However, its reliance on pattern deviation probability       
 
values causes a ceiling effect which may reduce its sensitivity to      
change in eyes with early damage. slope of MD (dB/y)  MD VFI
Fig 2) Slopes of VFI and MD over time. Venn diagram shows close Fig 3) Relationship between level of damage and
agreement between progression with VFI and MD. variability with MD (top) and VFI (bottom)