title: Study of Optimal Perimetric Testing In Children (OPTIC): development and feasibility of the kinetic perimetry reliability measure (KPRM).
abstract: Interpretation of perimetric findings, particularly in children, relies on accurate assessment of test reliability, yet no objective measures of reliability exist for kinetic perimetry. We developed the kinetic perimetry reliability measure (KPRM), a quantitative measure of perimetric test reproducibility/reliability and report here its feasibility and association with subjective assessment of reliability.
  
  
  
  Children aged 5-15 years, without an ophthalmic condition that affects the visual field, were recruited from Moorfields Eye Hospital and underwent Goldmann perimetry as part of a wider research programme on perimetry in children. Subjects were tested with two isopters and the blind spot was plotted, followed by a KPRM. Test reliability was also scored qualitatively using our examiner-based assessment of reliability (EBAR) scoring system, which standardises the conventional clinical approach to assessing test quality. The relationship between KPRM and EBAR was examined to explore the use of KPRM in assessing reliability of kinetic fields.
  
  
  
  A total of 103 children (median age 8.9 years; IQR: 7.1 to 11.8 years) underwent Goldmann perimetry with KPRM and EBAR scoring. A KPRM was achieved by all children. KPRM values increased with reducing test quality (Kruskal-Wallis, p=0.005), indicating greater test-retest variability, and reduced with age (linear regression, p=0.015). One of 103 children (0.97%) demonstrated discordance between EBAR and KPRM.
  
  
  
  KPRM and EBAR are distinct but complementary approaches. Though scores show excellent agreement, KPRM is able to quantify within-test variability, providing data not captured by subjective assessment. Thus, we suggest combining KPRM with EBAR to aid interpretation of kinetic perimetry test reliability in children.
authors.affiliation: Life Course Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, UK.|Ulverscroft Vision Research Group, London, UK.|NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.|Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors.forename: Dipesh E
authors.initials: DE
authors.lastname: Patel
authors.affiliation: NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: Ananth C
authors.initials: AC
authors.lastname: Viswanathan
authors.affiliation: NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Garway-Heath
authors.affiliation: Life Course Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, UK.|Ulverscroft Vision Research Group, London, UK.
authors.forename: Phillippa M
authors.initials: PM
authors.lastname: Cumberland
authors.affiliation: Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.|Ulverscroft Vision Research Group, London, UK.
authors.forename: Bronwen C
authors.initials: BC
authors.lastname: Walters
authors.affiliation: Ulverscroft Vision Research Group, London, UK.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Russell-Eggitt
authors.affiliation: Clinical Epidemiology, Nutrition and Biostatistics Section, UCL Institute of Child Health, London, UK.
authors.forename: Mario
authors.initials: M
authors.lastname: Cortina-Borja
authors.affiliation: Life Course Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, UK.|Ulverscroft Vision Research Group, London, UK.|NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK.|Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
authors.forename: Jugnoo S
authors.initials: JS
authors.lastname: Rahi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D009898:Optic Disk; D011446:Prospective Studies; D015203:Reproducibility of Results; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D058609:Visual Field Tests / Q000592:standards*; D014794:Visual Fields / Q000502:physiology*
keywords: Child health (paediatrics); Diagnostic tests/Investigation; Field of vision