Sensitivity and specificity of the Swedish interactive threshold algorithm for glaucomatous visual field defects

PURPOSE: To determine the sensitivity and specificity of two new visual field algorithms in detecting glaucomatous visual field defects: (1) Swedish interactive threshold algorithm (SITA) standard and (2) SITA fast. DESIGN: Prospective observational case series. PARTICIPANTS: Ninety normal subjects and 82 glaucoma patients. TESTING: Central 30 degrees fields were performed with the Humphrey visual field analyzer 30-2 program (Humphrey Systems, Dublin, CA) using full threshold, SITA standard, and SITA fast algorithms on the same day for two or more sessions within a 1-month period. MAIN OUTCOME MEASURES: Sensitivity and specificity in detecting glaucomatous visual field defects with SITA standard and SITA fast using full threshold testing as the reference standard. RESULTS: The sensitivity of SITA standard and SITA fast in detecting glaucomatous defects overall was 98% and 95%, respectively. In the subset of mild glaucomatous field defects (26 patients), sensitivity of SITA standard was 92% versus 85% with SITA fast. Sensitivity was 100% for both algorithms in moderate to severe glaucomatous defects. Specificity for glaucoma defects using SITA standard and SITA fast was 96% for both algorithms. SITA standard reduced test-taking time from full threshold by 52% in normal subjects and 47% in glaucoma patients (P < 0.001). SITA fast reduced test-taking time by 72% in normal subjects and 65% in glaucoma patients (P < 0.001). Mean deviation values were 0.4 dB and 0.8 dB better in SITA standard and SITA fast fields, respectively, in normal subjects (P < 0.001), and 0.7 dB and 1.2 dB in SITA standard and SITA fast fields, respectively, in glaucoma patients (P < 0.001) compared with full threshold values. CONCLUSIONS: The new algorithms for measuring visual fields, SITA standard and SITA fast, have excellent sensitivity and specificity for glaucomatous visual field loss with considerable savings in time.