Bayer A. U.

Departments of Ophthalmology of the University Hospital Tuebingen and the Hospital of Weilheim-Schongau

Purpose: To evaluate the clinical use of short-wavelength-automated perimetry (SWAP) in predicting progressive glaucomatous visual field defects on standard automated perimetry (SAP) and in detecting glaucoma in eyes with suspect discs but normal results on SAP.
Methods: 79 POAG patients with SAP defects in one eye and normal SAP in the contralateral eye and 79 normal controls were enrolled. In addition, 182 patients with POAG with bilateral defects on SAP were followed over a period of 36 months. At each study session, SWAP was performed on both eyes of patients and normal controls.
Results: Contralateral POAG eyes with asymmetric SAP showed significant differences in SWAP (p=0.0003). When comparing between POAG eyes with normal results on SAP and normal controls, SWAP showed significant differences (p<0.0001); ROC analysis revealed a promising accuracy for SWAP of 79.9% and of 93.1% in POAG eyes with SAP defects. Using the criteria of progressive field loss on SAP defined by the Collaborative Normal Tension Glaucoma Study, 70 out of 182 POAG patients showed progressive defects. SWAP early detected progressive defects on SAP in 55 out of the 70 eyes (78.6%).
Conclusion: SWAP can detect glaucomatous optic neuropathy in POAG eyes with normal standard visual fields and is able to predict the progression of glaucomatous standard visual field defects.

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