SITA standard, SITA fast, tendency-oriented perimetry (TOP) e perimetria de frequencia dupla (FDT) em individuos submetidos a perimetria computadorizada pela primeira vez / SITA standard, SITA fast, tendency-oriented perimetry (TOP) and frequency-doubling technology perimetry in perimetrically inexperienced individuals

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

The aim of this study was to evaluate the sensitivity and specificity of the screening mode of Frequency-Doubling Technology (FDT), Tendency-Oriented Perimetry (TOP), SITA Standard (SS) and SITA Fast (SF) for the diagnosis of glaucoma in perimetrically inexperienced individuals. One eye of 64 glaucoma patients and 53 normal subjects who had never undergone automated perimetry were tested with programs C-20-5 (FDT), G1 (TOP), and 24-2 (SS and SF), during a single visit on the same day. The order of tests was randomly assigned for each subject, with an interval of approximately 15-30 minutes. The gold standard for the diagnosis of glaucoma was based on the presence of a typical glaucomatous optic disc appearance, and intraocular pressure (IOP) ? 21mmHg. To define an abnormal visual field, we applied three criteria for SS and SF and two criteria for TOP and FDT, all of them previously described in the literature. SS and SF results were considered abnormal if: 1) the glaucoma hemifield test (GHT) was borderline or outside normal limits; 2) if the pattern deviation probability map showed a cluster of three or more nonedge points deviating at p<5%, one of which deviating at p<1%; or 3) if pattern standard deviation (PSD) was increased to values deviating at p<5%. The TOP test was considered abnormal: 1) if the mean defect (MDe) >2dB and/or the loss variance (LV) >6dB, and/or 2) if there were at least seven points (three of them contiguous) with a reduction in sensitivity of 5dB or more in the corrected comparisons graphic. FDT test results were considered abnormal if 1) there was the presence of at least one abnormal location (p<5%, p<2% or p<1%); and 2) there were two or more abnormal locations regardless of the severity of abnormal points. Comparative analyses of the sensitivities and specificities of each criterion were carried out, including 1) All the exams regardless of the order of application; 2) Only the first exams. Comparative analyses of times for test completion and percentage of unreliable tests were also performed. FDT showed the shortest mean test duration, followed by TOP, SF and SS (p<0.0001). Glaucomatous patients had longer test times (p<0.05), but not statistically significant more unreliable visual fields than normal subjects for all tests (p>0.05). Sensitivities ranged from 87.5 - 89.1% for SS, 92.2 - 93.8% for SF, 87.5 - 89.1% for TOP and 82.8 - 85.9% for FDT (p=0.34). Specificities ranged from 73.6 - 83% for FDT, 56.6 - 62.3% for TOP, 60.4 - 69.8% for SF and 66 - 71.7% for SS. The specificity obtained with criterion 2 for FDT (based on the presence of two or more abnormal locations regardless of the severity of abnormal points) was higher than those measured with the other strategies (p<0.01). When only the first exams were compared, sensitivities were 78.6% for FDT, 94.1% for TOP, 89.5% for SS, and varied between 92.7 and 100% for SF (p=0.63). Specificities were 76.9% for FDT, and in the range of 53.9 - 61.5% for TOP, 57.1 - 71.4% for SF and 76.9 - 84.6% for SS (p=0.65). In conclusion, when testing individuals with no perimetric experience, moderate sensitivities and specificities should be expected, regardless of the strategy chosen

ASSUNTO(S)

visual fields glaucoma campos visuais sensibilidade perimetry glaucoma perimetria sensitivity

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