Anxiety and Visual Field Assessment Reliability in Glaucoma Patients

Background: Visual field assessment is very important for the diagnosis and monitoring of glaucoma. Anxiety may affect the quality of a patient’s performance when undergoing these assessment tests and influence the reliability of visual field measurement.

Methods: A total of 155 primary and secondary glaucoma patients were recruited. Face-to-face interviews using the Beck Anxiety Inventory (BAI) questionnaire were conducted prior to Humphrey visual field analysis (HFA) assessment testing. The reliability indices of fixation loss, false positive error, and false negative error were used to determine the accuracy of the HFA measurement.

Results: Based on the BAI, 122 patients were classified with minimal anxiety, 21 with mild anxiety, and 12 patients had moderate to severe anxiety. There was no correlation between BAI score and the reliability indices of the HFA. An increase in the number of previously conducted HFA tests reduced fixation loss by 1.3% (95% confidence interval (CI) [-2.394, -0.110], P = .032). There was a negative linear relationship between age and false positive error. For every 1 year increase in age, there was a 0.2% reduction in false positive error (95% CI [-0.376, -0.059], P = .008). Higher education level reduced the false negative errors by 3.5% (95% CI [-6.640, -0.279], P = .028).

Conclusions: Minimal anxiety may not affect the reliability indices of HFA. Age, education level, and number of previous visual field tests are the major factors affecting the reliability of visual field.