NEGATIVE THOUGHTS (CATASTROPHIZING) DURING HUMPHREY VISUAL FIELDS ARE RELATED TO DECREASED TEST RELIABILITY IN GLAUCOMA PATIENTS

Hull Auditorium

Objective. We sought to gain a better understanding of whether glaucoma patients’ negative thoughts during Humphrey visual field (HVF) testing were related to HVF variability. Background. HVF tests are often unreliable in glaucoma patients, but continue to play a vital role in glaucoma clinical trials and clinical decision-making. Methods. We adapted the Pain Catastrophizing Scale to assess negative thoughts (e.g., can’t stand it; feel it’s awful; fear of failing or doing poorly; something serious may happen; anxiously want it to end) related to vision loss and HVF test performance. We administered this catastrophizing questionnaire to 52 glaucoma patients within 20 minutes of HVF test completion during a routine clinic visit. HVF variability of the mean deviation score [coefficient of variation (CoV)] was based on the last 3-4 tests obtained in the past 4 years. Results. A quarter of patients (13/52) demonstrated catastrophizing during HVF testing (i.e., their responses mapped well to the questionnaire items), while the others had little to no catastrophizing. Increased catastrophizing (i.e., Rasch analysis person measure score) was significantly associated with higher mean HVF false positives (p=0.03) and increased HVF CoV (p=0.03). Catastrophizing was not significantly correlated with HVF false negatives or fixation losses (p > 0.50). Catastrophizing was significantly greater among subjects who reported increased sleepiness (i.e., relaxed, not fully alert) vs. wide awake (p=0.045). Conclusion. Glaucoma patients who have negative thoughts (catastrophizing) are more prone to exhibit false positive responses and reduced HVF test reliability. Future research should evaluate behavioral interventions for at-risk patients to attempt to improve accuracy for detecting functional vision losses. Grants. HPD research grant award