{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T06:28:53Z","timestamp":1767421733218,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T00:00:00Z","timestamp":1639008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Relationships between age and visual field (VF) reliability indices were investigated using a large real-world dataset (42,421 VF data points from 11,525 eyes of 5930 subjects). All VFs tested and stored at Shimane University Hospital between 1988 and 2019 were exported. Correlations between age, mean deviation (MD), pattern standard deviation (PSD), and reliability indices including fixation losses (FLs), false negatives (FNs), and false positives (FPs) were analyzed. The mean \u00b1 standard deviation age was 65.0 \u00b1 15.1 years; MD\u2014\u22126.9 \u00b1 8.1 decibels (dB); PSD\u20146.3 \u00b1 4.6 dB; FL\u20148.6 \u00b1 11.7%; FN\u20145.3 \u00b1 8.3%; and FP\u20142.6 \u00b1 5.0%. Univariate analyses showed strong associations between age and FNs (correlation coefficient, \u03c1 = 0.20, p &lt; 0.0001) and MD (\u03c1 = \u22120.21, p &lt; 0.0001). All FLs, FNs, and FPs were lowest during the third decade (20\u201329 years) of life. FLs were elevated consistently after that decade, and FNs were elevated sharply after the seventh decade. FPs were relatively stable after the fourth decade (30\u201339 years). Mixed-effect regression analyses in subjects 40 years and older showed that older age was associated with worse FLs (p &lt; 0.0001) and FNs (p &lt; 0.0001) but not FPs (p = 0.4126). Aging affects FLs and FNs with different modes but had minimal effects on FPs. Decreased VF sensitivity, deteriorated macular function, and technical difficulties with testing may be mechanisms of age-related changes in FLs and FNs.<\/jats:p>","DOI":"10.3390\/jcm10245775","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T21:46:58Z","timestamp":1639086418000},"page":"5775","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Real-World Analysis of the Aging Effects on Visual Field Reliability Indices in Humans"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0019-8857","authenticated-orcid":false,"given":"Tomoki","family":"Shirakami","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Omura","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Asaoka","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan"},{"name":"Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka 430-8558, Japan"},{"name":"Seirei Christopher University, Shizuoka 422-8545, Japan"},{"name":"Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka 422-8529, Japan"},{"name":"The Graduate School for the Creation of New Photonics Industries, Shizuoka 431-1202, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6512-7203","authenticated-orcid":false,"given":"Masaki","family":"Tanito","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Shimane University, Izumo 693-8501, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1016\/j.ajo.2007.12.003","article-title":"The importance of rates in glaucoma","volume":"145","author":"Caprioli","year":"2008","journal-title":"Am. J. Ophthalmol."},{"key":"ref_2","first-page":"2654","article-title":"Properties of perimetric threshold estimates from Full Threshold, SITA Standard, and SITA Fast strategies","volume":"43","author":"Artes","year":"2002","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"5985","DOI":"10.1167\/iovs.12-10428","article-title":"The relationship between variability and sensitivity in large-scale longitudinal visual field data","volume":"53","author":"Russell","year":"2012","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3667","DOI":"10.1167\/iovs.18-24303","article-title":"Differences in the Relation Between Perimetric Sensitivity and Variability Between Locations Across the Visual Field","volume":"59","author":"Gardiner","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/0002-9394(89)90006-8","article-title":"Test-retest variability in glaucomatous visual fields","volume":"108","author":"Heijl","year":"1989","journal-title":"Am. J. Ophthalmol."},{"key":"ref_6","first-page":"417","article-title":"Response variability in the visual field: Comparison of optic neuritis, glaucoma, ocular hypertension, and normal eyes","volume":"41","author":"Henson","year":"2000","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5630","DOI":"10.1167\/iovs.15-17576","article-title":"The Relationship Between Visual Acuity and the Reproducibility of Visual Field Measurements in Glaucoma Patients","volume":"56","author":"Matsuura","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1001\/jamaophthalmol.2017.6836","article-title":"Detection of Glaucoma Progression in Individuals of African Descent Compared With Those of European Descent","volume":"136","author":"Gracitelli","year":"2018","journal-title":"JAMA Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1001\/jamaophthalmol.2017.1279","article-title":"Association Between Neurocognitive Decline and Visual Field Variability in Glaucoma","volume":"135","author":"Daga","year":"2017","journal-title":"JAMA Ophthalmol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1001\/archopht.1986.01050190079043","article-title":"Age-related changes of the normal visual field","volume":"104","author":"Jaffe","year":"1986","journal-title":"Arch. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1667","DOI":"10.1016\/0002-9394(67)93644-6","article-title":"Studies on the effects of age on the central and peripheral isopters of the visual field in normal subjects","volume":"63","author":"Drance","year":"1967","journal-title":"Am. J. Ophthalmol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/S0039-6257(01)00299-5","article-title":"Identification of progressive glaucomatous visual field loss","volume":"47","author":"Spry","year":"2002","journal-title":"Surv. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/00061198-199400310-00007","article-title":"Eye Movements During Perimetry and the Effect that Fixational Instability Has on Perimetric Outcomes","volume":"3","author":"Demirel","year":"1994","journal-title":"J. Glaucoma"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Hirasawa, K., Kobayashi, K., Shibamoto, A., Tobari, H., Fukuda, Y., and Shoji, N. (2018). Variability in monocular and binocular fixation during standard automated perimetry. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0207517"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1136\/bjo.2007.135012","article-title":"Practical recommendations for measuring rates of visual field change in glaucoma","volume":"92","author":"Chauhan","year":"2008","journal-title":"Br. J. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.1001\/archophthalmol.2011.224","article-title":"Influence of visual field testing frequency on detection of glaucoma progression with trend analyses","volume":"129","author":"Zarei","year":"2011","journal-title":"Arch. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6776","DOI":"10.1167\/iovs.12-10049","article-title":"Visual field progression in glaucoma: Estimating the overall significance of deterioration with permutation analyses of pointwise linear regression (PoPLR)","volume":"53","author":"Chauhan","year":"2012","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"6077","DOI":"10.1167\/iovs.15-16957","article-title":"More Accurate Modeling of Visual Field Progression in Glaucoma: ANSWERS","volume":"56","author":"Zhu","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"6233","DOI":"10.1167\/iovs.15-17661","article-title":"The Usefulness of Gaze Tracking as an Index of Visual Field Reliability in Glaucoma Patients","volume":"56","author":"Ishiyama","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"4632","DOI":"10.1167\/iovs.05-1598","article-title":"Assessment of false positives with the Humphrey Field Analyzer II perimeter with the SITA Algorithm","volume":"47","author":"Newkirk","year":"2006","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"7010","DOI":"10.1167\/iovs.12-10268","article-title":"Factors that influence standard automated perimetry test results in glaucoma: Test reliability, technician experience, time of day, and season","volume":"53","author":"Wesselink","year":"2012","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"8149","DOI":"10.1167\/iovs.14-15541","article-title":"An objective evaluation of gaze tracking in Humphrey perimetry and the relation with the reproducibility of visual fields: A pilot study in glaucoma","volume":"55","author":"Ishiyama","year":"2014","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1034\/j.1600-0420.2000.078005519.x","article-title":"Reliability of computerized perimetric threshold tests as assessed by reliability indices and threshold reproducibility in patients with suspect and manifest glaucoma","volume":"78","author":"Bengtsson","year":"2000","journal-title":"Acta Ophthalmol. Scand."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7801","DOI":"10.1167\/iovs.15-17988","article-title":"Estimating the Usefulness of Humphrey Perimetry Gaze Tracking for Evaluating Structure-Function Relationship in Glaucoma","volume":"56","author":"Ishiyama","year":"2015","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1097\/IAE.0b013e3180ed4571","article-title":"Fixation characteristics of patients with macular degeneration recorded with the mp-1 microperimeter","volume":"28","author":"Markowitz","year":"2008","journal-title":"Retina"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/j.jcjo.2013.05.006","article-title":"Fixation stability as a goal in the treatment of macular disease","volume":"48","author":"Mandelcorn","year":"2013","journal-title":"Can. J. Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S0161-6420(85)34065-4","article-title":"A clinical comparison of visual field testing with a new automated perimeter, the Humphrey Field Analyzer, and the Goldmann perimeter","volume":"92","author":"Beck","year":"1985","journal-title":"Ophthalmology"},{"key":"ref_28","first-page":"2201","article-title":"False-negative responses in glaucoma perimetry: Indicators of patient performance or test reliability?","volume":"41","author":"Bengtsson","year":"2000","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1097\/00006324-199908000-00027","article-title":"Normal aging effects for frequency doubling technology perimetry","volume":"76","author":"Adams","year":"1999","journal-title":"Optom. Vis. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s10654-017-0270-y","article-title":"Incidence of glaucomatous visual field loss after two decades of follow-up: The Rotterdam Study","volume":"32","author":"Springelkamp","year":"2017","journal-title":"Eur. J. Epidemiol."},{"key":"ref_31","first-page":"268","article-title":"Fatigue effects during a single session of automated static threshold perimetry","volume":"35","author":"Hudson","year":"1994","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/S0161-6420(91)32231-0","article-title":"Time-related variation in normal automated static perimetry","volume":"98","author":"Searle","year":"1991","journal-title":"Ophthalmology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e833","DOI":"10.1111\/aos.14069","article-title":"Does eye examination order for standard automated perimetry matter?","volume":"97","author":"Kelly","year":"2019","journal-title":"Acta Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1001\/archopht.124.6.781","article-title":"Effect of eye testing order on automated perimetry results using the Swedish Interactive Threshold Algorithm standard 24-2","volume":"124","author":"Barkana","year":"2006","journal-title":"Arch. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.ophtha.2019.11.021","article-title":"Predictors of Long-Term Visual Field Fluctuation in Glaucoma Patients","volume":"127","author":"Rabiolo","year":"2020","journal-title":"Ophthalmology"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/24\/5775\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T07:44:28Z","timestamp":1760168668000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/24\/5775"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,9]]},"references-count":35,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["jcm10245775"],"URL":"https:\/\/doi.org\/10.3390\/jcm10245775","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2021,12,9]]}}}