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Comparison of Glaucomatous Visual Field Defects Using Standard Full Threshold and Swedish Interactive Threshold Algorithms
Donald L. Budenz, MD;
Paul Rhee, OD;
William J. Feuer, MS;
John McSoley, OD;
Chris A. Johnson, PhD;
Douglas R. Anderson, MD
Arch Ophthalmol. 2002;120:1136-1141.
Objectives To compare the severity, size, and depth of glaucomatous visual field
defects using standard full threshold (FT), Swedish interactive threshold
algorithm (SITA) standard (SS), and SITA fast (SF) algorithms of the Humphrey
perimeter.
Methods A prospective observational case series of 77 patients with glaucoma
performed FT, SS, and SF 30-2 white-on-white testing programs on the same
day on 2 occasions for 1 month. The severity of defects was compared using
the mean deviation, pattern standard deviation, Advanced Glaucoma Intervention
Study, and Hodapp-Anderson-Parrish severity scores. The sizes of defects were
compared using the total number of abnormal points on the pattern deviation
plot that fit standard criteria for glaucomatous visual field defects. The
depths of the defects were compared using the sum of the threshold values
for points identified in the pattern deviation plot as fitting criteria for
glaucomatous defects.
Results The mean deviations were slightly better using the SS (-9.6 ±
7.1 dB) or the SF (-9.1 ± 6.7 dB) algorithm compared with the
FT algorithm (-10.3 ± 7.1 dB) (P<.005). There
were no significant differences in pattern standard deviations between SS
(8.6 ± 4.0, P = .08) and SF (8.1 ±
3.6, P = .19) compared with FT (8.3 ± 3.3),
although the pattern standard deviation was higher in SS fields compared with
SF fields (P<.001). Advanced Glaucoma Intervention
Study scores were slightly better when the SS (7.5 ± 5.6) or SF (7.2
± 5.4) algorithm was used compared with the FT algorithm (8.6 ±
5.4) (P<.001). The sizes of glaucomatous defects
were slightly larger using the SS (20.9 ± 10.7) algorithm compared
with the FT algorithm (19.2 ± 10.9) (P = .004)
but not the SF algorithm (20.0 ± 10.6) (P
= .11). The depth of defects measured by the SS (220.4 ± 108.0 dB)
and SF (219.8 ± 101.3 dB) algorithms was significantly shallower compared
with that measured by the FT algorithm (152.3 ± 79.1 dB) (P<.001). There were no significant differences in Hodapp-Anderson-Parrish
severity scores among algorithms (P = .12).
Conclusions Glaucomatous defects are measured significantly shallower using the
new SITA algorithms but are approximately the same size and severity compared
with FT measurements. Care should be taken when using threshold values to
compare glaucomatous defects in a patient when converting from FT to SITA
algorithms.
From the Bascom Palmer Eye Institute, Department of Ophthalmology,
University of Miami School of Medicine, Miami, Fla (Drs Budenz, Rhee, McSoley,
and Anderson and Mr Feuer), and Department of Ophthalmology, University of
California, Davis, Sacramento (Dr Johnson). Dr Johnson is now affiliated with
Devers Eye Institute, Portland, Ore.
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