Diagnostic Ability and Repeatability of a New Supra-Threshold Glaucoma Screening Program in Standard Automated Perimetry

Abstract

PurposeWe assess the diagnostic ability and repeatability of a new suprathreshold glaucoma screening test (GST) comprising 28 test points and a 1-of-3 sampling strategy at 95% of the normal limit for standard automated perimetry (SAP) in early to advanced glaucoma.MethodsThis prospective cross-sectional study included 96 eyes of patients with early, moderate, or advanced glaucoma and 37 eyes of normal controls. Participants were evaluated by the G-Dynamic threshold test once and the GST twice, in random order, using the Octopus 600 perimeter. The diagnostic ability of GST was assessed by comparison with the G-Dynamic threshold obtained by receiver operating characteristic analysis. Repeatability was assessed by κ statistics for agreement on glaucoma diagnosis and each test point.ResultsAlthough the G-Dynamic test exhibited significantly higher areas under the curve (AUC) than the GST1st (P = 0.009) in early glaucoma, there were no significant differences in any other AUCs between the two methods. The κ values for repeatability of glaucoma diagnosis and each test point were 0.747 to 1.0 and 0.537 to 1.0, respectively. The duration of the GST in the control and early glaucoma groups was less than a minute, while that in the moderate and advanced glaucoma groups was within 1.5 minutes.ConclusionThe diagnostic ability of the new suprathreshold GST for early to advanced glaucoma was high, with moderate to strong repeatability and short test duration.Translational RelevanceThere currently are no prominent suprathreshold screening strategies using SAP. The GST would be an effective clinical method for glaucoma screening.

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“…Slit lamp biomicroscopy and ophthalmoscopy were conducted to ensure the absence of ocular pathology and those with cataract grading above 1 in The Lens Opacities Classification System III were not included in the study ( Chylack et al, 1993 ). A supra-threshold glaucoma screening test (white-on-white Goldmann Size III targets) was performed using the Octopus 600 perimeter (Haag-Streit AG, Köniz, Switzerland) ( Takahashi et al, 2017 ; Turpin, Myers, & McKendrick, 2016 ) and only those participants with no visual field defects were included.…”