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Swedish interactive thresholding algorithm fast for following visual fields in prepubertal idiopathic intracranial
Hadas Stiebel-Kalish1, Moshe Lusky, Yiftah Yassur
1Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel. kalishh@clalit.org.il
Insights
Swedish Interactive Thresholding Algorithm Fast (SITA Fast) visual fields (VFs) are reliable for children aged 4 and older with idiopathic intracranial hypertension (IIH). A child-oriented program improves outcomes by shortening testing time.
Area of Science:
- Ophthalmology
- Pediatric Neurology
- Neuro-ophthalmology
Background:
- Idiopathic intracranial hypertension (IIH) can affect children, necessitating reliable visual field (VF) testing for monitoring.
- Assessing visual function in prepubertal children with IIH presents unique challenges due to age and cooperation.
- Swedish Interactive Thresholding Algorithm Fast (SITA Fast) offers a potentially quicker method for VF testing.
Purpose of the Study:
- To evaluate the reliability of SITA Fast visual field tests in prepubertal children diagnosed with idiopathic intracranial hypertension (IIH).
- To determine if factors such as age, gender, or the severity of visual impairment influence the reliability of SITA Fast VF tests.
- To compare the testing duration of SITA Fast with the Fastpac strategy.
Main Methods:
- A prospective, longitudinal cohort study was conducted involving 26 prepubertal children (<11 years) with IIH.
- Children underwent SITA Fast visual field testing as part of a child-oriented follow-up program.
- Statistical analyses, including ANOVA, point-biserial correlation, and chi-square tests, were used to correlate test reliability with age, gender, and visual outcome severity.
Main Results:
- SITA Fast VF tests were found to be reliable in children as young as 4 years old.
- Test duration for SITA Fast averaged 4.5 minutes per eye, significantly shorter than the 8 minutes for Fastpac.
- Reliability was not significantly associated with age, gender, or the severity of visual outcome.
Conclusions:
- SITA Fast visual field testing is a reliable and time-efficient method for assessing visual function in prepubertal children with IIH, starting from age 4.
- A child-oriented follow-up program incorporating shortened testing times may enhance outcomes for this patient group.
- Early implementation of reliable VF testing aids in managing visual deficits associated with IIH in children.
Objective:
To examine the reliability of Swedish Interactive Thresholding Algorithm Fast (SITA Fast) visual fields (VFs) in prepubertal idiopathic intracranial hypertension (IIH) and to compare whether age, gender, or severity of visual outcome influenced the reliability of VF tests.
Design:
Prospective, longitudinal cohort study.
Participants:
Twenty-six prepubertal children (<11 years of age; mean age, 7.2 years) with IIH.
Testing:
Children were prospectively followed up using a child-oriented program, which included SITA Fast VF tests. Age, gender, and severity of visual outcome were correlated with reliability of performance on SITA Fast VFs using a 1-way analysis of variance, point-biserial correlation, and the chi-square test for independence of observation.
Main Outcome Measures:
Statistical analyses results that correlated the reliability of SITA Fast VFs with age, gender, and visual outcome.
Results:
Three children were treated at the age of 2 years and were unable to perform automated VF tests. Four children were treated at the age of 4 years, 3 of whom were able to perform repeatable reliable SITA Fast VF tests. Forty-two eyes of 21 children had an average SITA Fast test time of 4.5 minutes for each eye, compared with 8 minutes using the Fastpac strategy. Age was not associated with reliability scores of SITA Fast tests (F = 0.971, not significant [ns]). Gender did not influence the reliability of SITA Fast VF tests (chi-square((1)) = 0.669, ns), nor did severity of visual outcome (chi-square((2)) = 3.348, ns). Visual deficits were observed in 55% of patients at presentation and in 27% of patients after resolution of papilledema.
Conclusions:
The SITA Fast VF tests can be performed from age 4 years and offer a reliable method for shortening test time. A child-oriented follow-up program, which entails a shortened testing time, may improve outcome in prepubertal IIH.
