Comparison of the new perimetric GATE strategy with conventional full-threshold and SITA standard strategies.
OBJECTIVE
A new, fast-threshold strategy, German Adaptive Thresholding Estimation (GATE/GATE-i), is compared to the full-threshold (FT) staircase and the Swedish Interactive Thresholding Algorithm (SITA) Standard strategies. GATE-i is performed in the initial examination and GATE refers to the results in subsequent examinations.


METHODS
Sixty subjects were recruited for participation in the study: 40 with manifest glaucoma, 10 with suspected glaucoma, and 10 with ocular hypertension. The subjects were evaluated by each threshold strategy on two separate sessions within 14 days in a randomized block design.


RESULTS
SITA standard, GATE-i, and GATE thresholds were 1.2, 0.6, and 0.0 dB higher than FT. The SITA standard tended to have lower thresholds than those of FT, GATE-i, and GATE for the more positive thresholds, and also in the five seed locations. For FT, GATE-i, GATE, and SITA Standard, the standard deviations of thresholds between sessions were, respectively, 3.9, 4.5, 4.2, and 3.1 dB, test-retest reliabilities (Spearman's rank correlations) were 0.84, 0.76, 0.79, and 0.71, test-retest agreements as measured by the 95% reference interval of differences were -7.69 to 7.69, -8.76 to 9.00, -8.40 to 8.56, and -7.01 to 7.44 dB, and examination durations were 9.0, 5.7, 4.7, and 5.6 minutes. The test duration for SITA Standard increased with increasing glaucomatous loss.


CONCLUSIONS
The GATE algorithm achieves thresholds that are similar to those of FT and SITA Standard, with comparable accuracy, test-retest reliability, but with a shorter test duration than FT.
Schiefer
Ulrich
U
Centre for Ophthalmology, Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany. ulrich.schiefer@med.uni-tuebingen.de
Pascual
John P
JP
Edmunds
Beth
B
Feudner
Elisabeth
E
Hoffmann
Esther M
EM
Johnson
Chris A
CA
Lagrèze
Wolf A
WA
Pfeiffer
Norbert
N
Sample
Pamela A
PA
Staubach
Flemming
F
Weleber
Richard G
RG
Vonthein
Reinhard
R
Krapp
Elke
E
Paetzold
Jens
J
D000328:Adult; D000465:Algorithms; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D009798:Ocular Hypertension / Q000175:diagnosis / Q000503:physiopathology; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012607:Scotoma / Q000175:diagnosis* / Q000503:physiopathology; D012684:Sensory Thresholds; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields