Comparison of Advanced Threshold and SITA Fast Perimetric Strategies

Abstract

Purpose. To compare the results obtained with two threshold strategies of visual field assessment: Humphrey SITA Fast (SFA) (Carl Zeiss Meditec) and PTS 2000 Advanced Threshold (ADV) (Optopol Technology) in healthy subjects and patients with glaucoma. Methods. The study sample comprised of 53 healthy volunteers and 69 patients with glaucoma. One eye of each patient was examined with the SFA and ADV strategies. The quantitative comparisons of test duration and global indices were made using correlation coefficients. The sensitivity and specificity of the algorithms were evaluated based on the GHT results and the adjusted Anderson–Patella (A&P) criteria. Results. The ADV test duration was shorter both in healthy subjects (by 5%) and patients with glaucoma (by 18%). The mean differences in MS values between the SFA and the ADV strategies were 1.06 ± 1.13 dB (MSSFA-MSADV) in healthy subjects and 1.00 ± 1.92 dB (MSSFA-MSADV) in patients with glaucoma. The MD index of ADV tests was lower than the SFA in the healthy (−0.74 ± 1.09 dB) (MSSFA-MSADV) and glaucoma group (−0.85 ± 2.19 dB) (MSSFA-MSADV). The mean differences in PSD values determined using both methods were −0.86 ± 0.67 dB (PSDSFA-PSDADV) and −0.53 ± 1.48 dB (PSDSFA-PSDADV) in healthy subjects and patients with glaucoma, respectively. Analysis of receiver operating characteristic curves built from MD and PSD indices show bigger area under curve in SFA than in ADV (0.983 vs.0.968 and 0.986 vs. 0.938, respectively). The GHT-based sensitivity and specificity for the ADV strategy were 92.75% and 77.36%, respectively, as compared to 92.75% and 90.57%, respectively, for the SFA strategy. Conclusions. Both SFA and ADV enable effective identification of glaucomatous defects within 5 minutes. The ADV strategy, however, is significantly faster. The correlation between the global indices of SFA and ADV is very high. Both strategies offer very high sensitivity when using both GHT and A&P criteria.

Visual fields in glaucoma: Where are we now?

“…However, SFer consistently shows smaller visual field deficits, making the results between the two algorithms uninterchangeable 13 . Despite this, SF and SFer have similar test–retest variability and a similarly high sensitivity of 92.8% and 92.8%, respectively 14,19,20 …”

“…14,15,17,18 Along with having similar test-retest variabilities, both SFer and SS have comparable visual field deficit sensitivities of 92.8% and 95.1% and specificities of 68.0% and 61.0%, respectively. 14,17,19,20 Although the algorithms show no significant difference in their mean deviations (MD) for mild or suspect glaucoma patients, SFer tends to show milder results for moderate or severe glaucoma. This difference may lead to disease progression being concealed when transferring from SS to SFer.…”

“…13 Despite this, SF and SFer have similar test-retest variability and a similarly high sensitivity of 92.8% and 92.8%, respectively. 14,19,20 A more recent version of SFer is the SITA Faster 24-2c (SFer-c) which includes 10 additional points from the 10-2 pattern to detect changes in the central visual field. 23 Due to the additional test points, SFer-c takes around 20-30 s longer.…”

“…Despite the differences between the two algorithms, the overall visual field parameters show good agreement, where the visual field index (VFI), foveal threshold, glaucoma hemifield test, and the number of depressed points on the deviation probability maps are similar 14,15,17,18 . Along with having similar test–retest variabilities, both SFer and SS have comparable visual field deficit sensitivities of 92.8% and 95.1% and specificities of 68.0% and 61.0%, respectively 14,17,19,20 . Although the algorithms show no significant difference in their mean deviations (MD) for mild or suspect glaucoma patients, SFer tends to show milder results for moderate or severe glaucoma.…”

Comparison of ZETA Fast (PTS) (Optopol Technology) and Humphrey SITA Fast (SFA) (Carl Zeiss Meditec) Perimetric Strategies

“…Automated perimetry remains the clinical standard for visual field assessment and determination of glaucomatous progression despite this era of rapidly evolving optical coherence tomography (OCT)-based diagnostic instrumentation [ 1 – 4 ]. It provides not only an estimation of retinal sensitivity and minimum threshold values to visual stimuli but also can confirm the functional effects of pathological findings discovered with other testing methods.…”