Integrated visual fields: a new approach to measuring the binocular field of view and visual disability

Background: We have developed a method of quantifying the central binocular visual field by merging results from monocular fields ( Integrated visual field). This study aims to compare the new measure with the binocular Esterman visual field test in identifying patients with self-reported visual disability. Methods: Forty-eight patients with glaucoma each recorded Humphrey 24-2 fields for both eyes and an Esterman on the same day, and each completed a binary forced-choice questionnaire relating to perceived visual disability. Computer software merged sensitivity values from monocular fields to generate an integrated visual field and a related score of the number of defects at the < 10 dB and < 20 dB level. Receiver operating characteristic ( ROC) analysis was used to compare the integrated visual field score and the Esterman disability score with individual responses to the questions on perceived difficulty with visual tasks. Results: Comparison of areas under ROC curves revealed that a score based on the integrated visual field was generally better ( median area: 0.79) than Esterman scores ( median area: 0.70) in classifying patients with or without a self-reported perceived difficulty with visual tasks. Conclusions: The integrated visual field offers a rapid assessment of a glaucoma patient's binocular visual field without extra perimetric testing. As compared to an actual binocular field test ( Esterman), the integrated visual field provides a better prediction of a glaucoma patient's perceived inability to perform certain visual tasks.