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Editors Selection IGR 19-3

Visual function

Comment by Balwantray Chauhan on:

11950 The prevalence of glaucomatous defects with short-wavelength automated perimetry in patients with elevated intraocular pressures, Reus NJ; Colen TP; Lemij HG, Journal of Glaucoma, 2005; 14: 26-29

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Short-wavelength automated perimetry (SWAP) is perhaps the non-conventional perimetric technique with the longest experience. Some studies have shown that SWAP can predict the development and progression of standard automated perimetry (SAP) defined visual field defects. Published literature has stated that the proportion of ocular hypertensive subjects with SWAP defects varies from 0.4% to 36%. This large variation is not surprising given the different inclusion criteria as well as criteria for SWAP abnormalities. Reus et al. (136) have investigated the effect of changing the definition of a SWAP abnormality on the prevalence rates of SWAP defects in a clinical population of ocular hypertensive subjects. Using seven criteria, they found that the prevalence of SWAP defects varied from 0% to 9.9% depending on the strictness of the criterion.The authors included only those subjects with a normal SAP visual field and, while they contend that the appearance of the optic disc was not a selection criterion, it may have been a selection criterion for referral into their clinic. In spite of this, since the criteria were investigated on the same group of subjects, they were able to obtain some meaningful information. The authors did not (were not in a position to, given the nature of the study) determine the optimum criterion for the definition of SWAP visual field defects. Such important questions remain to be answered. Perhaps laboratories with longitudinal SWAP data may be able to review the sensitivity and specificity of various criteria based on the change in visual field and optic disc parameters using the various techniques.

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