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

Abstract

Prcis: 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 86-89% while those for the SS test ranged from 84-88%. 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.