Diagnostic Accuracy of Smart Supra Perimetry in Comparison With Standard Automated Perimetry in the Detection of Early Glaucoma.

PRÉCIS: The diagnostic performance for detecting early glaucoma of a supra-threshold and a threshold visual field tests are compared. Their performance was found to be equivalent with the supra-threshold test being faster.

PURPOSE: To compare the diagnostic accuracy of a supra-threshold and a threshold visual field test in detecting early glaucoma using optical coherence tomography (OCT) as the reference standard.

METHODS

Data from 54 early/suspect glaucoma patients and 37 controls underwent a Humphrey Visual field Analyzer (HFA) SITA standard 24-2 threshold test, a Henson 9000 Smart Supra test (SS) supra-threshold test and Topcon Triton OCT scan: Smart Track 3D Wide (H) (12 × 9). OCT data were classified by 3 experts as either no glaucoma (n=42), suspect (n=6), or glaucoma (n=43). Overall and Selective global indices and receiver operating characteristics (ROC) curve analysis were used to compare visual field outcomes with OCT classifications.

RESULTS

SS was significantly faster than SITA standard (3.9 vs. 6 min). Sixty-one percent of the glaucoma sample and 81% of controls showed substantial agreement between OCT and visual field testing using the most sensitive criteria (Henson-N-miss SS, stage 2 and 3, >0 misses; HFA VFI <99%). The area under the ROC curve showed good discrimination for all global indices. The 24-2 global indices MD, PSD, and VFI ranged from 86% to 89%, whereas those for the SS test ranged from 84% to 88%. Partial area under the ROC curve (80%-100% specificity) showed a fall for all global indices. HFA MD, PSD and VFI range (61%-73%), SS test range (71%-78%).

CONCLUSIONS

The SS supra-threshold test was faster and had equivalent diagnostic accuracy to the SITA standard 24-2 threshold test in early/suspect glaucoma.