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Comparative quantification of focal and diffuse visual field loss by the SPARK Precision threshold algorithm and SITA
S K Foo1, R P Cubbidge2,3, R Heitmar4,5
1Faculty of Optometry and Vision Sciences, SEGi University, Petaling Jaya, Malaysia.
Summary
The SPARK Precision algorithm is faster but less sensitive than the SITA Standard Humphrey Field Analyser (HFA) for detecting early glaucoma visual field loss. SPARK Precision may underestimate disease severity, potentially impacting long-term patient monitoring.
Area of Science:
- Ophthalmology
- Visual field testing
- Glaucoma diagnostics
Background:
- Visual field loss is a key indicator of glaucoma progression.
- Accurate and efficient visual field testing is crucial for diagnosis and management.
- Comparing novel algorithms to established standards is essential for clinical adoption.
Purpose of the Study:
- To compare the threshold agreement between the SPARK Precision algorithm (Oculus Twinfield 2) and the SITA Standard Humphrey Field Analyser (HFA) algorithm.
- To evaluate the performance of SPARK Precision in detecting focal (glaucoma) and diffuse (cataract) visual field loss.
- To assess the time efficiency and diagnostic accuracy of the SPARK Precision algorithm.
Main Methods:
- 39 treated glaucoma patients and 31 cataract patients were tested with both Oculus Twinfield 2 (SPARK Precision) and HFA 3 (SITA Standard).
- Visual field data including Mean Sensitivity (MS), Mean Deviation (MD), and Pattern Standard Deviation (PSD) were analyzed.
- Glaucoma severity was classified using the AGIS score.
Main Results:
- SPARK Precision testing was approximately twice as fast as SITA Standard.
- While MS showed good correlation, MD and PSD were significantly less severe with SPARK Precision in both glaucoma and cataract groups.
- Poor agreement was found for global indices, with significant proportional bias in MD and PSD. SPARK Precision yielded higher threshold estimates in the nasal field and lower AGIS scores for glaucoma severity.
Conclusions:
- SITA Standard detects deeper visual field defects than SPARK Precision.
- SPARK Precision may not adequately quantify early glaucomatous field loss due to its algorithm and the Twinfield 2's dynamic range.
- The plateau effect in SPARK Precision, while not clinically significant in early glaucoma, could impede long-term monitoring of disease progression.
