title: Influence of learning effect on blue-on-yellow perimetry.
abstract: OBJECTIVE
  Some studies have found that a significant blue-on-yellow perimetry (B/YP) learning effect exists in patients with ocular hypertension (OHT) or open-angle glaucoma who were experienced in standard automated perimetry. However, very little is known about the B/YP learning effect in normal subjects and patients without previous white-on-white perimetry (W/WP) experience. Meanwhile, it is unclear whether the B/YP learning effect is influenced by age and refraction.
  
  
  METHODS
  Twenty healthy subjects, 26 OHT and 14 primary open angle glaucoma (POAG) patients, underwent three full-threshold B/YP tests at intervals of 7 to 21 days. Of the 60 subjects, 38 had no previous W/WP experiences, 22 had previous W/WP experiences for at least two times. The parameters investigated to detect a learning effect were the perimetric indices and the test duration (TD).
  
  
  RESULTS
  Learning effects were demonstrated for mean deviation (MD), pattern standard deviation (PSD), short-term fluctuation (SF), and TD. Significant differences were found between the MD, PSD, SF, and TD of the first test and those of the second and third tests (p<0.05). However, no difference was found between those parameters of the second and third tests. No statistically significant differences were noted in terms of MD1st-2nd, MD1st-3rd, PSD1st-2nd, PSD1st-3rd, TD1st-2nd, and TD1st-3rd between the group with W/WP experience and the group without previous W/WP experience (p>0.05). No statistically significant differences were noted in terms of those parameters among the normal subjects and the patients with OHT or POAG (p>0.05). No significant difference was found in the B/YP learning effect among various age groups (p>0.05) and among various refraction groups (p>0.05).
  
  
  CONCLUSIONS
  A significant learning effect was observed between the first and the second or third tests and the perimetric indices appeared improved at full-threshold B/YP. The previous W/WP experience and the subject age and refraction did not influence the B/YP learning effect. This above all should be taken into account when considering the clinical use of this test to avoid erroneous diagnostic conclusions.
authors.affiliation: Department of Ophthalmology, Ruijin Hospital Affiliated Shanghai Jiaotong University, Shanghai - China. yszhong68@yahoo.com.cn
authors.forename: Y
authors.initials: Y
authors.lastname: Zhong
authors.forename: L
authors.initials: L
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Cheng
authors.forename: P
authors.initials: P
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D003119:Color Perception Tests; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D007858:Learning; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis; D014786:Vision Disorders / Q000175:diagnosis*; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields