PURPOSE

No consensus exists on the relative superiority among criteria for evaluating glaucomatous visual field (VF) damage. We compared the sensitivities and specificities of 5 criteria—Glaucoma Hemifield Test (GHT), Hoddap-Anderson-Parrish 2 (HAP2), Foster, United Kingdom Glaucoma Treatment Study (UKGTS), and Low-pressure Glaucoma Treatment Study (LoGTS)—across various levels of functional and structural glaucomatous damage.

DESIGN

Retrospective cross-sectional study.

METHODS

This single-center study included patients with suspect or known glaucoma with reliable VF (Humphrey 24-2 Swedish Interactive Thresholding Algorithm) and optical coherence tomography (OCT; Spectralis, Heidelberg Engineering) examinations within a 4-month period. One eye per patient was included. The level of functional and structural damage was defined by mean deviation (MD) and by an OCT score, respectively. We created the OCT score by counting the number of abnormal (MD percentile [P] <1%) global and sectoral averages of optic nerve head MRW, circumpapillary RNFL thickness, and macular GCL thickness. We inferred specificities and sensitivities from positive rates of the criteria in patients with low glaucomatous damage (MD at P ≥ 10% or OCT score = 0) and with higher damage (MD at P < 10% or OCT score > 0), respectively.

RESULTS

We included 1230 patients. In patients with low glaucomatous damage, HAP2 and UKGTS had higher positive rates, suggesting lower specificities, whereas GHT, Foster, and LoGTS had lower positive rates, suggesting higher specificities. In patients with higher glaucomatous damage, HAP2 and UKGTS had higher positive rates, indicating higher sensitivities, whereas GHT, Foster, and LoGTS had lower positive rates, indicating lower sensitivities.

CONCLUSIONS

No criteria had uniformly superior performance. Selection of criteria should consider the degree of damage anticipated and the desire for either higher sensitivity or specificity.<END ABSTRACT>

中文翻译：

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比较评估青光眼视野的五个标准

目的

在评估青光眼视野 (VF) 损伤的标准之间的相对优越性方面，尚无共识。我们比较了 5 项标准的敏感性和特异性——青光眼半场测试 (GHT)、Hoddap-Anderson-Parrish 2 (HAP2)、Foster、英国青光眼治疗研究 (UKGTS) 和低压青光眼治疗研究 (LoGTS)。不同程度的功能性和结构性青光眼损伤。

设计

回顾性横断面研究。

方法

这项单中心研究包括在 4 个月内进行可靠 VF（Humphrey 24-2 瑞典交互式阈值算法）和光学相干断层扫描（OCT；Spectralis，Heidelberg Engineering）检查的疑似或已知青光眼患者。包括每位患者一只眼睛。功能和结构损伤的程度分别由平均偏差 (MD) 和 OCT 评分定义。我们通过计算视神经乳头 MRW、视乳头周围 RNFL 厚度和黄斑 GCL 厚度的异常（MD 百分位 [P] <1%）全球和部门平均值的数量来创建 OCT 评分。我们分别从低青光眼损伤（MD，P ≥ 10% 或 OCT 评分 = 0）和高损伤（MD，P < 10% 或 OCT 评分 > 0）患者的标准阳性率推断出特异性和敏感性。

结果

我们纳入了 1230 名患者。在青光眼损伤低的患者中，HAP2 和 UKGTS 的阳性率较高，表明特异性较低，而 GHT、Foster 和 LoGTS 的阳性率较低，表明特异性较高。在青光眼损伤较高的患者中，HAP2和UKGTS的阳性率较高，表明敏感性较高，而GHT、Foster和LoGTS的阳性率较低，表明敏感性较低。

结论

没有标准具有一致的优越性能。标准的选择应考虑预期的损害程度以及对更高敏感性或特异性的期望。<END ABSTRACT>