Comparative Analysis of 24-2C, 24-2, and 10-2 Visual field Tests for Detecting Mild-Stage Glaucoma with Central Visual field Defects

PurposeThis study sought to identify the most effective testing program for detecting visual-field defects in mild-stage glaucoma with central visual-field defects.DesignA multicenter, retrospective diagnostic testing evaluation.ParticipantsThe study involved 93 eyes (83 patients) with mild-stage glaucoma (median mean deviation interquartile range: -1.79 2.16 dB) with central visual-field defects and 69 eyes (63 patients; median mean deviation, -1.38 2.31 dB) with mild-stage glaucoma without central visual-field defects, from Jikei University School of Medicine and Tajimi Iwase Eye Clinic.MethodsPatients underwent 10-2 Swedish Interactive Thresholding Algorithm (SITA) Standard, 24-2 SITA Standard, and 24-2C SITA Faster tests. Central visual-field defects were defined using 10-2 SITA Standard and optical coherence tomography (OCT). A detection power of 4 points in the 24-2 that coincided with 10-2 (Center4), 12 points that lie within 10° (24-2-12), and 22 points that lie within 10° of 24-2C (24-2C-22) were analyzed using receiver operating characteristic (ROC) curves based on logistic regression analysis, using total deviation (TD) and pattern deviation (PD) probability plots.Main Outcome MeasuresArea under the receiver operating characteristic curve (AUC) of the Center4, 24-2-12, and 24-2C-22 tests.ResultsIn the upper-central visual field, AUCs of the TD plot were 0.50 (0.40–0.58) for the Center4, 0.75 (0.67–0.83) for 24-2-12, and 0.85 (0.78–0.91) for 24-2C-22, with 24-2C-22 AUC significantly exceeding 24-2-12 AUC. For the PD plot, AUCs were 0.53 (0.44–0.63), 0.81 (0.74–0.89), and 0.84 (0.77–0.90), respectively. In the lower-central visual field, using a total plot, AUCs were 0.27 (0.18–0.36), 0.57 (0.47–0.69), and 0.57 (0.46–0.68) for the Center4, 24-2-12, and 24-2C-22, respectively. Using the PD plot in the upper field, AUCs were 0.27 (0.19–0.36), 0.64 (0.53–0.75), and 0.81 (0.72–0.90), respectively, with the AUC of the 24-2C-22 significantly exceeding that of 24-2-12. The 24-2C test was significantly faster than both the 24-2 and 10-2 tests, reducing testing duration by 46% and 52%, respectively.ConclusionsThe 24-2C SITA Faster test is highly effective and efficient for detecting mild-stage glaucoma with central visual-field defects. This, and its reduced duration, makes it a valuable tool in clinical settings.