Abstract
Abstract: :
Purpose: A prospective cross-sectional study to compare reliability and agreement between the Frequency Doubling Technology Full-Threshold (FDT) and Swedish interactive technology algorithm Standard (SITA) automated perimetry in children. Methods: Pediatric patients of the Duke Eye Center were evaluated. Inclusion criteria were: 1. Diagnosis of normal, glaucoma suspect, or glaucoma; 2. Visual acuity at least 20/50; 3. No retinal or neurological disease. If both eyes qualified, then the eye with the best visual acuity was used. Patients took both tests on the same day in a randomized order. Three masked expert observers graded the randomized SITA fields using the Hodapp, Anderson, Parrish criteria (Hodapp et al, 1993) and the randomized FDT fields using criteria reported by Sponsel, et.al. (AJO 1998). Ocular Hypertension Treatment Study visual field criteria (Gordon, Arch Ophth, 1999) were used to determine reliability. Adjudication by two of three observers was used to determine the final grade of field damage and test reliability. Statistical analysis was performed with the subjects split into three age groups: (years: 6-8, 9-11, 12-15), and by clinical diagnosis. Results: Forty-six eyes of 46 patients (8 glaucoma, 17 Glaucoma Suspect, 21 Normal) were used. Twenty-three Caucasian and 23 African-American subjects were included. Mean age was 10.29 +/- 2.41 years. The average difference between FDT (5.69 +/- 0.6 minutes) and SITA (6.63 +/- 1.47minutes) test taking time was 0.94 +/- 1.42 minutes and was statistically significant (p<0.001). The time difference was greatest in the youngest group, 6.00+/- 0.57 v. 7.86 +/- 1.38 minutes (p<0.001). There was a statistically significant difference (p<0.001) between the false negatives of FDT (2.61 +/- 8.01%) and SITA (15.0 +/- 45.0%). There was no statistically significantly difference between the number of false positives between FDT (6.0 +/- 9.4%) and SITA (6.2 +/- 6.5%). FDT had 60.87% reliable tests v. 65.22% for SITA (p=0.63, Κ=0.16). Conclusions: FDT may be more easily utilized by younger patients as it takes less time. The SITA's higher false negative rate may be secondary to loss of attention over time. There was similar reliability between FDT and SITA, but poor agreement between the two tests. Therefore, if a child is unable to reliably perform one test, it is worthwhile attempting the other technology. FDT may be a viable pediatric perimetric test, especially at younger ages.