Does saving time using FASTPAC or suprathreshold testing reduce quality of visual fields?

PURPOSE

To compare the clinical performance of two time-saving test strategies in detecting visual field abnormalities.

METHODS

One eye of 48 healthy subjects and 87 patients with glaucoma and early visual field loss was tested with the Humphrey perimeter. After an initial 24-2 standard threshold test, three tests using the 24-2 array of test locations were performed in randomized order: standard threshold strategy, FASTPAC threshold strategy, and threshold-related suprathreshold screening strategy. The initial 24-2 test was used as the "gold standard" against which the other three tests were compared.

RESULTS

Mean threshold values were 0.3 decibels more sensitive using FASTPAC than the standard threshold test, whereas short-term fluctuation was 0.5 decibels larger. Measured using different criteria for abnormality, sensitivity and specificity of FASTPAC were no different than those of the standard threshold test, but they were better than the suprathreshold screening. Using a very sensitive measure of defect detection in ten different clusters within the field, the standard strategy and FASTPAC performed similarly yet significantly better than the suprathreshold test.

CONCLUSIONS

In healthy subjects and patients with early glaucoma, FASTPAC saves 40% of test time without a significant deterioration in defect detection, whereas 52-point suprathreshold screening is not a clinically acceptable alternative.