Faculty of Optometry and Vision Sciences, SEGi University, Petaling Jaya, Malaysia.
College of Health and Life Science, School of Optometry, Aston University, Birmingham, UK.
Graefes Arch Clin Exp Ophthalmol. 2022 Jun;260(6):1983-1993. doi: 10.1007/s00417-021-05430-7. Epub 2021 Dec 28.
The aims of this paper were to examine focal and diffuse visual field loss in terms of threshold agreement between the widely used SITA Standard Humphrey Field Analyser (HFA) threshold algorithm with the SPARK Precision algorithm (Oculus Twinfield 2).
A total of 39 treated glaucoma patients (34 primary open angle and 5 primary angle closure glaucoma) and 31 cataract patients without glaucoma were tested in succession with the Oculus Twinfield 2 (Oculus Optikgeräte GmbH, Wetzlar, Germany) using the SPARK Precision algorithm and with the HFA 3 (Carl Zeiss Meditec, Dublin, CA) using the 30-2 SITA Standard algorithm.
SPARK Precision required around half the testing time of SITA Standard. There was a good correlation between the MS of the two threshold algorithms but MD and PSD were significantly less severe with SPARK Precision in both glaucoma (focal field loss) and cataract (diffuse field loss) groups (p < 0.001). There was poor agreement for all global indices (MS, MD and PSD) between the two algorithms and there was a significant proportional bias of MD in the glaucoma group and PSD in both glaucoma and cataract groups. The pointwise sensitivity analysis yielded higher threshold estimates in SPARK Precision than in SITA Standard in the nasal field. Classification of glaucoma severity using AGIS was significantly lower with SPARK Precision compared to SITA Standard (p < 0.001).
SITA renders deeper defects than SPARK. Compared to the SITA Standard threshold algorithm, SPARK Precision cannot quantify early glaucomatous field loss. This may be due to the mathematical linear interpolation of threshold sensitivity or deeper scotomas due to the plateau effect caused by the reduced dynamic range of the Twinfield 2 perimeter. Although not of clinical significance in early glaucoma, the plateau effect may hinder the long-term follow-up of patients during disease progression.
本文旨在探讨广泛应用的 SITA Standard Humphrey 视野分析仪（HFA）阈值算法与 SPARK Precision 算法（Oculus Twinfield 2）之间的阈值一致性，以评估局灶性和弥漫性视野损失。
连续对 39 例经治疗的青光眼患者（34 例原发性开角型青光眼和 5 例原发性闭角型青光眼）和 31 例无青光眼的白内障患者使用 Oculus Twinfield 2（Oculus Optikgeräte GmbH，德国威茨拉尔）进行 SPARK Precision 算法检测，使用 HFA 3（Carl Zeiss Meditec，加利福尼亚州都柏林）进行 30-2 SITA Standard 算法检测。
SPARK Precision 算法的测试时间约为 SITA Standard 算法的一半。两种阈值算法的 MS 相关性较好，但在青光眼（局灶性视野损失）和白内障（弥漫性视野损失）组中，SPARK Precision 算法的 MD 和 PSD 均显著较轻（p<0.001）。两种算法的所有全局指标（MS、MD 和 PSD）之间的一致性较差，在青光眼组中 MD 存在显著比例偏差，在青光眼和白内障组中 PSD 存在显著比例偏差。逐点敏感性分析显示，在鼻侧视野中，SPARK Precision 算法的阈值估计值高于 SITA Standard 算法。使用 AGIS 对青光眼严重程度进行分类时，SPARK Precision 算法明显低于 SITA Standard 算法（p<0.001）。
SITA 算法比 SPARK 算法得出的缺损更深。与 SITA Standard 阈值算法相比，SPARK Precision 算法不能定量评估早期青光眼的视野损失。这可能是由于阈值敏感性的数学线性插值，或者由于 Twinfield 2 周边动态范围缩小导致的平台效应造成的更深的暗点。虽然在早期青光眼患者中无临床意义，但平台效应可能会阻碍疾病进展期间患者的长期随访。
