Research Mentor Name

Hassan Tokko, MD

Research Mentor Email Address

htokko@med.wayne.edu

Institution / Department

Kresge Eye Institute, Detroit MI

Document Type

Research Abstract

Research Type

clinicalresearch

Graduate Level Research

no

Abstract

Title: Effect of Pre-Training Patients Using a Self-Directed Slideshow Presentation on Visual Field Reliability in First-Time Test Takers

Authors: Lillian Centlivre BS, Derek Zahnleuter BS, Rahul Babu BS, Chaesik Kim BSEE, Kaitlin Ziadeh MD, Hanna Simmons MD, Vivian Rajeswaren MD, Aleksey Parker Williams DO, Jacob Im MD, Aleksey Mishulin MD, Faisal Ridha Al-Timimi MD, Hassan Tokko MD

Background: Visual field (VF) testing is essential for detecting glaucoma, but reliability is limited by patient inexperience and poor fixation. Prior studies report VF test reliability around 59%, primarily attributed to increased fixation loss (FL). Other studies note 75.9% reliability using training videos in VF-naïve patients. The impact of self-directed education on VF reliability remains unclear.

Methods: Randomized control trial including VF-naïve patients over 18 between April 2022 and June 2025. Eligibility required visual acuity (VA) of 20/200 or better, glaucoma or glaucoma suspect diagnosis, and a false-positive rate (FPR) ≤ 20%. Patients were randomized to an experimental group receiving a self-directed slideshow before testing or a control group with no intervention. Demographic and clinical data abstracted included age, sex, ethnicity, VA, intraocular pressure (IOP), FL, FPR, mean deviation (MD), pattern standard deviation (PSD), and glaucoma severity. VF tests were considered reliable if the FL was < 20%.

Results: 144 patients (72 experimental, 72 control) were analyzed. Groups did not differ significantly in VA (p=0.34), IOP (p=0.06), MD (p=0.45), PSD (p=0.74), or glaucoma severity (p=0.96). The experimental group was younger (p=0.03). Reliable VF tests occurred in 65% of the experimental group and 52% of the control group (p=0.29). High FL predicted reduced reliability (p< 0.0001). Reliability decreased among patients aged ≥ 65 across both groups (p=0.02).

Conclusion: While a self-directed slideshow improved VF test reliability, the difference was not statistically significant. Age-related decreases in VF reliability warrant further investigation, especially given the projected doubling of glaucoma prevalence by 2050.

Disciplines

Diagnosis | Eye Diseases | Interprofessional Education | Investigative Techniques | Medicine and Health Sciences | Ophthalmology | Optometry

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