Full-field stimulus threshold testing:a scoping review of current practice


The full-field stimulus threshold (FST) is a psychophysical measure of whole-field retinal light sensitivity. It can assess residual visual function in patients with severe retinal disease and is increasingly being adopted as an endpoint in clinical trials. FST applications in routine ophthalmology clinics are also growing, but as yet there is no formalised standard guidance for measuring FST. This scoping review explored current variability in FST conduct and reporting, with an aim to inform further evidence synthesis and consensus guidance. A comprehensive electronic search and review of the literature was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) checklist. Key source, participant, methodology and outcomes data from 85 included sources were qualitatively and quantitatively compared and summarised. Data from 85 sources highlight how the variability and insufficient reporting of FST methodology, including parameters such as units of flash luminance, colour, duration, test strategy and dark adaptation, can hinder comparison and interpretation of clinical significance across centres. The review also highlights an unmet need for paediatric-specific considerations for test optimisation. Further evidence synthesis, empirical research or structured panel consultation may be required to establish coherent standardised guidance on FST methodology and context or condition dependent modifications. Consistent reporting of core elements, most crucially the flash luminance equivalence to 0 dB reference level is a first step. The development of criteria for quality assurance, calibration and age-appropriate reference data generation may further strengthen rigour of measurement.

Publication DOI: https://doi.org/10.1038/s41433-023-02636-3
Divisions: College of Health & Life Sciences > School of Optometry > Audiology
College of Health & Life Sciences
Funding Information: This work was supported by the National Institute of Health and Care Research (NIHR) Great Ormond Street Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health
Additional Information: Copyright © The Author(s) 2023. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
Publication ISSN: 1476-5454
Last Modified: 21 Feb 2024 17:47
Date Deposited: 19 Jul 2023 08:58
Full Text Link:
Related URLs: https://www.nat ... 433-023-02636-3 (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Review article
Published Date: 2024-01
Published Online Date: 2023-07-13
Accepted Date: 2023-06-13
Authors: Shi, Linda F
Hall, Amanda J (ORCID Profile 0000-0001-8520-6005)
Thompson, Dorothy A



Version: Published Version

License: Creative Commons Attribution

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