Diagnostic sensitivity of fast blue-yellow and standard automated perimetry in early glaucoma - A comparison between different test programs

Purpose: To compare the ability of Fast Swedish interactive threshold algorithm (SITA) short-wavelength automated perimetry (SWAP), lengthier full-threshold SWAP, and standard automated perimetry (SAP) using the SITA Fast program to detect early glaucomatous visual field loss. Design: Cross-sectional prospective study of perimetric diagnostic sensitivity as defined by reference limits determined in the same healthy participants for all 3 test programs. Participants: One hundred one patients with ocular hypertension, or suspect or early manifest glaucoma. Methods: One eye of each patient was tested with 2 blue-yellow perimetric programs: the SITA and full-threshold SWAP and the SAP SITA Fast program. Main Outcome Measures: Glaucomatous visual field loss, defined as number of significantly depressed test point locations or the number of clusters of such test points. Results: No significant difference in number of significantly depressed test point locations between the 3 programs could be detected, neither at the P < 5% limit nor at the P < 2% limit. The difference in number of points depressed below the fifth percentile was 0.5 between full-threshold SWAP and SITA SWAP, 1.09 between full-threshold SWAP and SAP, and 1.04 between SITA SWAP and SAP. The number of eyes showing clusters of significantly depressed points also was similar with the 3 test programs: full-threshold SWAP identified clusters in 66 eyes, SITA SWAP identified clusters in 67 eyes, and SITA Fast SAP identified clusters in 65 eyes. Average test time was 12.0 minutes using full-threshold SWAP, 4.1 minutes with SITA SWAP, and 3.5 with SITA Fast. Conclusions: The SITA SWAP identified at least as much glaucomatous visual field loss as the older full-threshold SWAP, although test time was considerably reduced. Conventional SAP using SITA Fast was not significantly less sensitive than either of the 2 SWAP programs.