Predicting binocular visual field sensitivity from monocular visual field results

PURPOSE: To compare methods of predicting binocular visual field sensitivity of patients with glaucoma from monocular visual field data. METHODS: Monocular and binocular visual fields were obtained for 111 patients with varying degrees of glaucomatous damage in one or both eyes, using the Humphrey 30-2 full-threshold procedure. Four binocular sensitivity prediction models were evaluated: BEST EYE, predictions based on individual values for the most sensitive eye, defined by mean deviation (MD); AVERAGE EYE, predictions based on the average sensitivity between eyes at each visual field location; BEST LOCATION, predictions based on the highest sensitivity between eyes at each visual field location; and BINOCUIAR SUMMATION, predictions based on binocular summation of sensitivity between eyes at each location. Differences between actual and predicted binocular sensitivities were calculated for each model. RESULTS: The average difference between predicted and actual binocular sensitivities was close to zero for the BINOCULAR SUMMATION and BEST LOCATION models, with 95% of all predictions being within +/-3 dB of actual binocular sensitivities. The best eye (MD) prediction had an average error of 1.5 dB (95% confidence limits [CL], +/-3.7 dB). The average eye prediction was the poorest, with an average error of 3.7 dB (95% CL, +/-4.6 dB). CONCLUSIONS: The BINOCULAR SUMMATION and BEST LOCATION models provided better predictions of binocular visual field sensitivity than the other two models, with a statistically significant difference in performance. The small difference in performance between the BINOCULAR SUMMATION and BEST LOCATION models was not statistically significant. For evaluations of functional visual field influences on task performance, daily activities, and related quality-of-life issues, either the BINOCULAR SUMMATION or BEST LOCATION model provides good estimates of binocular visual field sensitivity.