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(Investigative Ophthalmology and Visual Science. 2006;47:1817-1823.)
© 2006 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.04-1345
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Functional Field Score: The Effect of Using a Goldmann V-4e Isopter Instead of a Goldmann III-4e Isopter

Maaike Langelaan,1,2 Bill Wouters,3 Annette C. Moll,1,2 Michiel R. de Boer,1,2 and Ger H. M. B. van Rens1,2,4

1From the Department of Ophthalmology, VU University Medical Centre, Amsterdam, The Netherlands; the 2Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam, The Netherlands; the 3Department of Research and Development, Visio Het Loo Erf, National Rehabilitation Centre for visually impaired adults, Apeldoorn, The Netherlands; and the 4Department of Ophthalmology, Elkerliek Hospital, Helmond, The Netherlands.

PURPOSE. To investigate the underestimation of field loss in functional field score (FFS) between the Goldmann isopters III-4e and V-4e in visually impaired patients, in order to develop a predictive model for the FFSIII-4e based on FFSv-4e that adjusts for possible confounders. Although the visual field is generally evaluated using Goldmann isopter III-4e, it has the disadvantage that not all low-vision patients are able to see the stimulus corresponding to this isopter.

METHODS. Goldmann visual fields were obtained from 58 patients with a variety of eye diseases. Eligibility criteria were age of 18 years or older and valid results of a Goldmann III-4e and V-4e visual field test in at least one eye. Linear regression was used to develop the model, setting FFSIII-4e as the dependent variable and FFSV-4e as the independent one.

RESULTS. The FFSV-4e was higher than the FFSIII-4e, the mean difference being 14.56 points (95% CI, 12.48 –16.64). Multiple linear regression analysis showed that age, functional acuity score, primary eye disease, and central–peripheral loss were not confounders for the prediction of FFSIII-4e. FFSIII-4e was estimated with the following equation: FFSIII-4e = –19.25 + 1.063 · FFSV-4e.

CONCLUSIONS. The relationship between FFSIII-4e and FFSV-4e is linear, and the FFSV-4e can be used to estimate the FFSIII-4e. In practice, just subtracting 19.25 points of the value of FFSV-4e will be sufficient to estimate the value of FFSIII-4e. This model should give confidence about using the bigger isopter for determining the visual impairment of a person by the FFS.






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