Reproducibility of visual field end point criteria for standard automated perimetry, full-threshold, and Swedish interactive thresholding algorithm strategies: diagnostic innovations in glaucoma study

Am J Ophthalmol. 2007 Dec;144(6):908-913. doi: 10.1016/j.ajo.2007.07.042. Epub 2007 Oct 24.

Abstract

Purpose: To compare the interthreshold and intrathreshold strategy agreement of visual field end point criteria for standard automated perimetry (SAP) with the full-threshold (FT) algorithm and the Swedish interactive threshold algorithm (SITA).

Design: Prospective, longitudinal cohort study.

Methods: The interstrategy group included a randomly selected eye of 173 participants in the Diagnostic Innovations in Glaucoma Study who had undergone FT algorithm and SITA analysis within three months (sequence 1, FT + SITA). Intrastrategy agreement for the FT algorithm (sequence 2, FT + FT) was tested for 44 (25.4%) participants who had undergone FT analysis within one year of the FT used in the interstrategy pairing, and for 89 patients (51.4%) who had undergone SITA analysis within one year before (sequence 3, SITA + SITA). Four different end point criteria using Statpac II indices were tested. Interstrategy agreement was compared with intrastrategy agreement using kappa statistics.

Results: FT + SITA agreement (kappa) for pattern standard deviation (PSD) < 1% was 0.82; for PSD < 5%, the kappa value was 0.64; and for four or more pattern deviation plot points, the kappa value was 0.43. Agreement with glaucoma hemifield test (GHT) results was significantly higher (P < .01) for FT + FT (kappa = 0.94) than FT + SITA (kappa = 0.67), and approached significance (P = .07) when comparing FT + FT with SITA + SITA (kappa = 0.77). GHT results were more likely to be abnormal on the SITA analysis than on the FT analysis. No other significant differences were found.

Conclusions: To minimize misinterpreting abnormal GHT results on SITA as evidence of change when switching strategies, both SITA and FT should be performed and compared within a short period. Other indices are comparable between the two strategies.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms*
  • Cohort Studies
  • Female
  • Glaucoma, Open-Angle / diagnosis*
  • Humans
  • Intraocular Pressure
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Optic Nerve Diseases / diagnosis*
  • Prospective Studies
  • Reproducibility of Results
  • Sensory Thresholds
  • Tonometry, Ocular
  • Vision Disorders / diagnosis*
  • Visual Field Tests / standards*
  • Visual Fields*