PURPOSE: No consensus exists on the relative superiority among criteria for evaluating glaucomatous visual field (VF) damage. We compared the sensitivities and specificities of five 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 suspect or known glaucoma patients with reliable VF (Humphrey 24-2 SITA) and OCT (Spectralis) examinations within a 4-month period; one eye per patient. 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 (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 obtained 1230 patients. In patients with low glaucomatous damage, HAP2 and UKGTS had higher positive rates suggesting lower specificities, while GHT, Foster, LoGTS had lower positive rates suggesting higher specificities. In patients with higher glaucomatous damage, HAP2 and UKGTS had higher positive rates indicating higher sensitivities while 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.
Dalhousie University Medical School, 5849 University Avenue, Halifax, Nova Scotia, Canada, B3H 4R2. Electronic address: email@example.com.