Glaucomatous visual fields. FASTPAC versus full threshold strategy of the Humphrey Field Analyzer.
OBJECTIVE
This study examined how FASTPAC, a fast strategy for the Humphrey Field Analyzer (HFA), compares to the standard 4/2-dB full threshold strategy in patients with glaucoma.


METHODS
The author tested one eye each of 50 patients with glaucoma (23 with only relative defects, 27 with at least one absolute defect; age range, 25 to 79 years; median age, 61.5 years) with both strategies using program 30-2 of the HFA (stimulus size III). Global visual field indices as calculated by Statpac, unweighted mean sensitivity, and examination time were compared. In addition, a point by point analysis of the sensitivity values was performed.


RESULTS
Between the two strategies, no significant differences were found for indices directly related to the sensitivity values (mean sensitivity [MS], mean deviation [MD]) or for the actual thresholds. For the entire population, FASTPAC showed higher mean short-term fluctuation (SF; P = 0.018), lower mean pattern standard deviation (PSD; P = 0.006), and mean corrected PSD (CPSD; P < 0.001) values and a time reduction of more than 30% (P < 0.001) compared to the standard strategy. These differences between the strategies were found to be independent of the amount of field loss, except for PSD (P = 0.001). No age influence was present. Statistically significant linear regression (r > 0.70, P < 0.001) was found between the FASTPAC values of MS, MD, PSD, CPSD, and the corresponding values determined with the standard strategy. No correlation exists for SF (r < 0.46, P > 0.030).


CONCLUSIONS
FASTPAC provides a considerable time reduction at the cost of higher threshold fluctuation. This may lead to problems in detecting relative defects or changes in differential light threshold in follow-up examinations.
Schaumberger
M
M
Section of Psychophysics and Physiological Optics, University Eye Hospital, Munich, Germany.
Schäfer
B
B
Lachenmayr
B J
BJ
D000328:Adult; D000368:Aged; D000465:Algorithms; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D014786:Vision Disorders / Q000175:diagnosis*; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields