Elsevier

Ophthalmology Glaucoma

Volume 6, Issue 2, March–April 2023, Pages 129-136
Ophthalmology Glaucoma

Original Article
24-2 SITA Standard versus 24-2 SITA Faster in Perimetry-Naive Normal Subjects

https://doi.org/10.1016/j.ogla.2022.08.006Get rights and content

Purpose

To compare the Swedish Interactive Thresholding Algorithm (SITA) Standard (SS) and SITA Faster (SFR) strategies in normal individuals undergoing standard automated perimetry (SAP) for the first time.

Design

Randomized, comparative, observational case series.

Participants

Seventy-four perimetry-naive healthy individuals.

Methods

All individuals underwent SAP 24-2 testing with the Humphrey Field Analyzer III (model 850 Zeiss) using the SS and SFR strategies. One eye of each individual was tested. Test order between strategies was randomized, and an interval of 15 minutes was allowed between the tests.

Main Outcome Measures

The following variables were compared: test time, foveal threshold, false-positive errors, number of unreliable tests, mean deviation (MD), visual field index (VFI), pattern standard deviation (PSD), glaucoma hemifield test (GHT), and number of depressed points deviating at P < 5%, P < 2%, P < 1%, and P < 0.5% on the total and pattern deviation probability maps. Specificity of the SS and SFR strategies were compared using Anderson’s criteria for abnormal visual fields.

Results

The SFR tests were 60.4% shorter in time compared with SS (P < 0.001) and were associated with a significantly lower PSD (1.75 ± 0.80 decibel [dB] vs. 2.15 ± 1.25 dB; P = 0.016). There were no significant differences regarding the MD, VFI, foveal threshold, GHT, and number of points depressed at P < 5%, P < 2%, P < 1%, and P < 0.5% on the total deviation and pattern deviation probability maps between SS and SFR. When all exams were analyzed and any of Anderson’s criteria was applied, the specificity was 68% with SFR and 61% with SS (P = 0.250). The specificities observed with SFR and SS when only the first or second exams were analyzed were also similar (63% vs. 64% and 72% vs. 58%, respectively, P > 0.05).

Conclusions

The SS and SFR were associated with similar specificities in perimetry-naive individuals. The SFR did not increase the number of depressed points in the total and pattern deviation probability maps. Ophthalmologists should be aware that both strategies are associated with disturbingly high false-positive rates in perimetry-naive individuals.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.

Section snippets

Methods

This was a cross-sectional, prospective study. The study protocol was approved by the Ethics Committee of the Pontificia Universidade Católica do Paraná and an informed consent was signed by all participants. All research adhered to the tenets of the Declaration of Helsinki. All subjects underwent a complete ophthalmological examination, including best-corrected visual acuity measurement, slit-lamp biomicroscopy, applanation tonometry, optic disc evaluation with a 78-diopter lens, and OCT for

Results

Among the 74 subjects included in the study, 55 (74%) were female and 65 (88%) were White. The mean age was 40.9 ± 12.1 years, ranging from 21.8 to 74.6 years. All participants had at least a high school degree and 35 (47%) had at least a graduate degree. Table 1 compares test duration, false-positive responses, number of unreliable exams, foveal threshold, MD, VFI, PSD, GHT, and number of points depressed at P < 5%, P < 2%, P < 1%, and P < 0.5% on the total deviation and pattern deviation

Discussion

SAP offers a standardized and efficient method to evaluate the hill of vision and has been employed for decades to diagnose and monitor functional glaucomatous damage.3,4 However, as a subjective test, it is affected by external factors, including visual fatigue.5,6 To overcome the influence of visual fatigue on the information provided by SAP, strategies have been developed to reduce test time. The SFR represents the latest development in this direction.12 However, before replacing SS with

Acknowledgments

The authors thank Zichao Wu and Abinaya Thenappan for providing preliminary MATLAB code for the visual field cluster criteria analysis.

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  • Supplemental material available at www.ophthalmologyglaucoma.org.

    Disclosure(s):

    All authors have completed and submitted the ICMJE disclosures form.

    The authors made the following disclosures: V.P.C.: Personal fees – Aerie Pharmaceuticals, Alcon, Allergan, Carl Zeiss Meditec, Glaukos, Iridex, Novartis.

    F.A.M.: Personal fees – Aerie Pharmaceuticals, Alcon, Allergan, Annexon, Biogen, Carl Zeiss Meditec, Gallimedix, Glaukos, Google, Iridex, nGoggle Inc, Novartis, Reichert, Santen.

    HUMAN SUBJECTS: Human subjects were included in this study. The Ethics Committee of the Pontificia Universidade Católica do Paraná approved the study. All participants provided informed consent. All research adhered to the tenets of the Declaration of Helsinki.

    No animal subjects were used in this study.

    Author Contributions:

    Conception and design: Costa, Zangalli, Jammal, Medeiros, Schimiti

    Data collection: Costa, Zangalli, Miyazaki, Perez, Boscaroli, Schimiti

    Analysis and interpretation: Costa, Zangalli, Jammal, Medeiros, Miyazaki, Perez, Boscaroli, Schimiti

    Obtained funding: N/A; Study was performed as part of the authors' regular employment duties. No additional funding was provided.

    Overall responsibility: Costa

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