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Editors Selection IGR 7-2

Examination methods: To SWAP or SAP; that's the question

Erik Greve

Comment by Erik Greve on:

14106 Diagnostic sensitivity of fast blue-yellow and standard automated perimetry in early glaucoma: a comparison between different test programs, Bengtsson B; Heijl A, Ophthalmology, 2006; 113: 1092-1097

See also comment(s) by Chris Johnson


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Every now and then a study appears that contradicts what we have believed and practiced based on prior well performed studies. We are inclined to dismiss the study as it 'just can't be true'. Such a study is reported by Bengtsson and Heijl (724), who compared SITA-SWAP, full-threshold-SWAP and SITA-Fast-SAP. Insiders will immediately recognize the abbreviations used as standing for SITA = Swedish Interactive Testing Algorithm; SWAP = Short Wavelength Automated Perimetry; and SAP = Standard Automated Perimetry.

Conventional SITA-fast-SAP was not significantly less sensitive than SITA-SWAP and fullthreshold-SWAP programs
One hundred and one patients (no not 1001) with OHT, suspect glaucoma or early manifest glaucoma were involved. Results were expressed as: significantly depressed test point locations or number of clusters of such points. The result: no difference between the three programs. Bengtsson and Heijl conclude that "conventional SITA-fast-SAP was not significantly less sensitive than either of the two SWAP programs." This finding certainly contradicts our present thinking that SWAP detects glaucoma damage earlier than SAP. Chris Johnson expresses his doubts:



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