Sensitivity and Specificity of Swedish Interactive Threshold Algorithm and Standard Full Threshold Perimetry in Primary Open-angle Glaucoma
Medical hypothesis discovery and innovation in ophthalmology,
Vol. 6 No. 4 (2017),
1 December 2017
,
Page 125-129
Abstract
Perimetry is one of the mainstays in glaucoma diagnosis and treatment. Various strategies offer different accuracies in glaucoma testing. Our aim was to determine and compare the diagnostic sensitivity and specificity of Swedish Interactive Threshold Algorithm (SITA) Fast and Standard Full Threshold (SFT) strategies of the Humphrey Field Analyzer (HFA) in identifying patients with visual field defect in glaucoma disease. This prospective observational case series study was conducted in a university-based eye hospital. A total of 37 eyes of 20 patients with glaucoma were evaluated using the central 30-2 program and both the SITA Fast and SFT strategies. Both strategies were performed for each strategy in each session and for four times in a 2-week period. Data were analyzed using the Student’s t-test, analysis of variance, and chi-square test. The SITA Fast and SFT strategies had similar sensitivity of 93.3%. The specificity of SITA Fast and SFT strategies was 57.4% and 71.4% respectively. The mean duration of SFT tests was 14.6 minutes, and that of SITA Fast tests was 5.45 minutes (a statistically significant 62.5% reduction). In gray scale plots, visual field defect was less deep in SITA Fast than in SFT; however, more points had significant defect (p < 0.5% and p < 1%) in pattern deviation plots in SITA Fast than in SFT; these differences were not clinically significant. In conclusion, the SITA Fast strategy showed higher sensitivity for detection of glaucoma compared to the SFT strategy, yet with reduced specificity; however, the shorter test duration makes it a more acceptable choice in many clinical situations, especially for children, elderly, and those with musculoskeletal diseases.References
Heijl A. The Humphrey Field Analyzer, Construction and Concepts. In: Heijl A, Greve E, editors. Sixth International Visual Field Symposium; Boston: W1985. p. 77-84.
Haley M. The Field Analyzer Primer. 2nd ed. San Leandro, CA: Allergan Humphrey; 1986.
Schulzer M. Errors in the diagnosis of visual field progression in normal-tension glaucoma. Ophthalmology. 1994;101(9):1589-94; discussion 95. doi: 10.1016/s0161-6420(94)31133-x pmid: 8090461
(AGIS) TAGIS. The advanced glaucoma intervention study (AGIS): 1. Study design and methods and baseline characteristics of study patients. Contr Clin Trials. 1994;15(4):299-325. doi: 10.1016/0197-2456(94)90046-9
Study AGI. Advanced Glaucoma Intervention Study. Ophthalmology. 1994;101(8):1445-55. doi: 10.1016/ s0161-6420(94)31171-7
Musch DC, Lichter PR, Guire KE, Standardi CL. The Collaborative Initial Glaucoma Treatment Study: study design, methods, and baseline characteristics of enrolled patients. Ophthalmology. 1999;106(4):653-62. pmid: 10201583
Gordon MO, Kass MA. The Ocular Hypertension Treatment Study: design and baseline description of the participants. Arch Ophthalmol. 1999;117(5):573-83. pmid: 10326953
Keltner JL, Johnson CA, Quigg JM, Cello KE, Kass MA, Gordon MO. Confirmation of visual field abnormalities in the Ocular Hypertension Treatment Study. Ocular Hypertension Treatment Study Group. Arch Ophthalmol. 2000;118(9):1187-94. pmid: 10980763
Hilton S, Katz J, Zeger S. Classifying visual field data. Stat Med. 1996;15(13):1349-64. pmid: 8841646
Caprioli J. Discrimination between normal and glaucomatous eyes. Invest Ophthalmol Vis Sci. 1992;33(1):153-9. pmid: 1730536
Johnson CA, Adams CW, Lewis RA. Fatigue effects in automated perimetry. Appl Opt. 1988;27(6):1030-7. doi: 10.1364/AO.27.001030 pmid: 20531515
Kocabeyoglu S, Uzun S, Mocan MC, Bozkurt B, Irkec M, Orhan M. Comparison of visual field test results obtained through Humphrey matrix frequency doubling technology perimetry versus standard automated perimetry in healthy children. Indian J Ophthalmol. 2013;61(10):576-9. doi: 10.4103/0301-4738.119322 pmid: 24145558
Hudson C, Wild JM, O'Neill EC. Fatigue effects during a single session of automated static threshold perimetry. Invest Ophthalmol Vis Sci. 1994;35(1):268-80. pmid: 8300355
Schwartz B, Takamoto T, Martin J. Increased rate of visual field loss associated with larger initial visual field threshold values on follow-up of open-angle glaucoma. J Glaucoma. 2004;13(2):120-9. pmid: 15097257
Sharma AK, Goldberg I, Graham SL, Mohsin M. Comparison of the Humphrey swedish interactive thresholding algorithm (SITA) and full threshold strategies. J Glaucoma. 2000;9(1):20-7. pmid: 10708227
Bengtsson B, Heijl A. Diagnostic sensitivity of fast blue-yellow and standard automated perimetry in early glaucoma: a comparison between different test programs. Ophthalmology. 2006;113(7):1092-7. doi: 10.1016/j.ophtha.2005.12.028 pmid: 16815399
Conway ML, Hosking SL, Zhu H, Cubbidge RP. Does the Swedish Interactive Threshold Algorithm (SITA) accurately map visual field loss attributed to vigabatrin? BMC Ophthalmol. 2014;14:166. doi: 10.1186/1471-2415-14-166 pmid: 25539569
Bengtsson B, Olsson J, Heijl A, Rootzen H. A new generation of algorithms for computerized threshold perimetry, SITA. Acta Ophthalmol Scand. 1997;75(4):368-75. pmid: 9374242
Olsson J, Bengtsson B, Heijl A, Rootzen H. An improved method to estimate frequency of false positive answers in computerized perimetry. Acta Ophthalmol
Scand. 1997;75(2):181-3. pmid: 9197569
Sekhar GC, Naduvilath TJ, Lakkai M, Jayakumar AJ, Pandi GT, Mandal AK, et al. Sensitivity of Swedish interactive threshold algorithm compared with standard full threshold algorithm in Humphrey visual field testing. Ophthalmology. 2000;107(7):1303-8. pmid: 10889102
Wild JM, Pacey IE, O'Neill EC, Cunliffe IA. The SITA perimetric threshold algorithms in glaucoma. Invest Ophthalmol Vis Sci. 1999;40(9):1998-2009. pmid: 10440254
Budenz DL, Rhee P, Feuer WJ, McSoley J, Johnson CA, Anderson DR. Sensitivity and specificity of the Swedish interactive threshold algorithm for glaucomatous visual field defects. Ophthalmology. 2002;109(6):1052-8. pmid: 12045043
Bengtsson B, Heijl A. SITA Fast, a new rapid perimetric threshold test. Description of methods and evaluation in patients with manifest and suspect glaucoma. Acta Ophthalmol Scand. 1998;76(4):431-7. pmid: 9716329
Wabbels BK, Wilscher S. Feasibility and outcome of automated static perimetry in children using continuous light increment perimetry (CLIP) and fast threshold strategy. Acta Ophthalmol Scand. 2005;83(6):664-9. doi: 10.1111/j.1600-0420.2005.005 26.x pmid: 16396642
Johnson CA, Sherman K, Doyle C, Wall M. A comparison of false-negative responses for full threshold and SITA standard perimetry in glaucoma patients and normal observers. J Glaucoma. 2014;23(5):288-92. doi: 10.1097/IJG.0b013e31829463 ab pmid: 23632399
- Abstract Viewed: 1638 times
- Full Text PDF Downloaded: 1336 times
