Validation of the SITA faster strategy for the management of glaucoma.

Abstract

To evaluate the SITA Faster strategy (SFR) in normal subjects and glaucoma patients. This randomized, controlled, cross-sectional study included 236 Visual fields (VFs) obtained from 59 subjects, grouped as controls, mild, moderate and severe glaucoma patients. All examinations were performed using the HFA-3 perimeter with the 24/2 program, adopting two strategies: the SITA Standard (SS) and SFR. Glaucoma severity was studied using continuous (mean defect -MD- and visual field index -VFI) and categorical (scoring systems from the AGIS and CIGTS studies) perimetric indices. There were no differences in the reliability indices obtained with both strategies when controls were compared to glaucoma patients. SFR significantly reduced the VF duration, saving 68% and 59.1% in glaucoma patients (60.8% in mild, 62.9% in moderate and 48.7% in severe glaucoma: p = 0.0004). The test duration was correlated with glaucoma severity, especially for the SFR (Spearman rho = -0.88, -0.82, 0.87 and 0.85 for the VFI, MD, AGIS and CIGTS, respectively). Although both strategies were correlated, the SS showed a greater severity of the defect in glaucoma patients (SS vs SFR VFI = 94.5 vs. 95, MD = -3.17 vs. -2.81, AGIS = 6 vs. 5, CIGTS = 4.85 vs. 3.41: p = 0.001). There was strong agreement between strategies, although this was lower in advanced glaucoma. The SFR strategy constitutes an adequate strategy to monitor glaucoma, especially in mild and moderate cases. Its speed allows more VFs to be assessed, as recommended in clinical practice guidelines.