Frontloading SITA-Faster Can Increase Frequency and Reliability of Visual Field Testing at Minimal Time Cost

Jeremy C K Tan; Michael Kalloniatis; Jack Phu

doi:10.1016/j.ogla.2023.03.006

Frontloading SITA-Faster Can Increase Frequency and Reliability of Visual Field Testing at Minimal Time Cost

Ophthalmol Glaucoma. 2023 Sep-Oct;6(5):445-456. doi: 10.1016/j.ogla.2023.03.006. Epub 2023 Mar 21.

Authors

Jeremy C K Tan¹, Michael Kalloniatis², Jack Phu³

Affiliations

¹ Faculty of Medicine and Health, University of New South Wales, Kensington, NSW, Australia; Department of Ophthalmology, Prince of Wales Hospital, Randwick, NSW, Australia.
² School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia; School of Medicine (Optometry), Deakin University, Waurn Ponds, Victoria, Australia.
³ School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Centre for Eye Health, UNSW, Sydney, NSW, Australia; Concord Clinical School, Concord Repatriation General Hospital, Concord, NSW, Australia. Electronic address: jack.phu@unsw.edu.au.

PMID: 36958625
DOI: 10.1016/j.ogla.2023.03.006

Abstract

Purpose: To report the outcomes of frontloaded visual field (VF) testing (2 tests per eye on the same visit) over 2 longitudinal, consecutive visits using SITA-Faster (SFR) in terms of global indices, reliability metrics, and test duration.

Design: Prospective longitudinal study.

Subjects: A total of 902 eyes of 463 subjects with normal, suspect, or manifest glaucoma.

Methods: Two intravisit SFR VF tests (T1 and T2) per eye at an initial (T_i) and follow-up (T_f) visit.

Main outcome measures: Intra- and intervisit global indices, reliability metrics, and test durations.

Results: The mean age of the subjects was 63.6 years, and 58.3% were male. Seven hundred ninety eyes (87.4%) had a diagnosis of glaucoma or glaucoma suspicion. The mean duration between visits was 265.0 (standard deviation 98.8) days. In total, 3608 VF tests were analyzed, with the correlation of mean deviation (MD) values of the frontloaded tests at each visit high (T1/T2 MD correlation at initial visit r = 0.83, root mean squared error [RMSE] = 1.26, follow-up visit r = 0.83, RMSE = 1.25, P < 0.0001) and greater than the correlation of MD between visits (T_i1/T_f1 MD correlation r = 0.72, RMSE = 1.31). There was a significant intra-visit decrease in rates of abnormally high sensitivity in the glaucoma hemifield test (3.2% vs. 1.6%, P = 0.0023) and rates of unreliable test results (15.4% vs. 9.2%, P = 0.002) from T1 to T2 in both visits, with a corresponding significant decrease in MD (-1.28 dB vs. -1.68 dB, P < 0.0001) and VF index (P = 0.03). The mean duration of each SFR test was 132.6 (SD 27.2) seconds.

Conclusions: Frontloading VFs using SFR produced sets of repeatable perimetric data with significant improvement of reliability indices from the first to second test. This may help increase testing frequency at minimal time cost to meet recommended guidelines and for evaluating patients prone to high variability.

Financial disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Keywords: Glaucoma; Humphrey field analyzer; Mean deviation; Perimetry; Progression; SITA-Faster; Static automated perimetry; Visual fields.

MeSH terms

Female
Glaucoma* / diagnosis
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Reproducibility of Results
Vision Disorders / diagnosis
Visual Field Tests / methods
Visual Fields*