Validation of the SITA faster strategy for the management of glaucoma.

Objective: To evaluate the SITA Faster strategy (SFR) in normal subjects and glaucoma patients.

Methods: This randomized, controlled, cross-sectional study included 236 Visual fields (VFs) obtained from 59 subjects, grouped as controls, mild, moderate and severe glaucoma patients. All examinations were performed using the HFA-3 perimeter with the 24/2 program, adopting two strategies: the SITA Standard (SS) and SFR. Glaucoma severity was studied using continuous (mean defect -MD- and visual field index -VFI) and categorical (scoring systems from the AGIS and CIGTS studies) perimetric indices.

Results: There were no differences in the reliability indices obtained with both strategies when controls were compared to glaucoma patients. SFR significantly reduced the VF duration, saving 68% and 59.1% in glaucoma patients (60.8% in mild, 62.9% in moderate and 48.7% in severe glaucoma: p = 0.0004). The test duration was correlated with glaucoma severity, especially for the SFR (Spearman rho = - 0.88, - 0.82, 0.87 and 0.85 for the VFI, MD, AGIS and CIGTS, respectively). Although both strategies were correlated, the SS showed a greater severity of the defect in glaucoma patients (SS vs SFR VFI = 94.5 vs. 95, MD = - 3.17 vs. - 2.81, AGIS = 6 vs. 5, CIGTS = 4.85 vs. 3.41: p = 0.001). There was strong agreement between strategies, although this was lower in advanced glaucoma.

Conclusions: The SFR strategy constitutes an adequate strategy to monitor glaucoma, especially in mild and moderate cases. Its speed allows more VFs to be assessed, as recommended in clinical practice guidelines.