The Earlier Diagnosis Value Of Short-wavelength Automated Perimetry (SWAP) In Primary Open-Angle Glaucoma (POAG)

[Objective]:This study was designed to evaluate the earlier diagnosis value of short-wavelength automated perimetry (SWAP) in the visual field loss o f Primary Open-Angle Glaucoma (POAG).[Methods]:With HumphreyⅡ-750i automated perimetry C24-2 SITA threshold testing procedures ,24 normal subjects (48 eyes), 37 patients (56 eyes) of suspect glaucoma, 19 patients (32 eyes) with early POAG were examined both by standard automatic perimetry (SAP) and the short-wavelength automated perimetry (SWAP) . Mean Deviation , (MD), Pattern Standard Deviation, (PSD) ,Glaucoma Hemifield Test,(GHT) and the points of visual field loss were recorded and analyzed. Perimetry results were considered valid if they were in line with these conditions: False Positive Errors rate was≤15%, false negative Errors rate≤15%, Fixation Loses rate≤20%. Statistical treatment: All the data were analyzed by SAS statistical software with P=0.05. Measurement data were signed byΧ±S, and rank sum test was used for them. Chi-square test was used for qualitative data.[Results]: Mean Deviation (MD) detected by SWAP in normal group,suspect glaucoma group and early POAG group were higher than that by SAP ,each of them had significant difference(P<0.05). The MD detected by SWAP in early POAG group was the highest one . Pattern Standard Deviation (PSD) detected by SWAP and SAP in three groups had significant difference(P<0.05). Both MD and PSD detected by SAP had no significant differences in normal group and suspect glaucoma group (P>0. 017),but the results had significant difference(P<0.017) in normal group and early POAG group, and the same results were detected in suspect glaucoma group and early POAG group. Both MD and PSD detected by SWAP had significant differences in three groups((P<0.017). in early POAG group: 19 eyes were detected to be abnormal by SAP with Glaucoma Hemifield Test(GHT), the sensitivity ratio was 59.38%(19/32); 27eyes were abnormal by SWAP ,the sensitivity ratio was 84.38%(27/32),the difference in the result of GHT by SAP and SWAP had statistical significance(p<0.05). The relative visual field defect points detected by SWAP were more than that by SAP in both suspect glaucoma group and early POAG group , and the difference was significant(P <0.05).[Conclusion]: 1.To compare the index of perimetry between two examining method in three groups, the numerical value of MD and PSD is the biggest in earlier POAG group detected by SWAP, and the index of perimetry detection by SWAP will descend while the data inspected by SAP descend. The absolute value inspected by SWAP is bigger than SAP, and the value inspected by SWAP will get along with the value inspected by SAP. The MD of SWAP is higher than SAP in loss depth, and we can conclude that the SWAP have deeper visual field loss, when the visual field loss were founded by SAP. In suspect glaucoma group and early POAG group , the deeper loss will be detected in SWAP. The change of each other is consistent, and the SAP has a good correspondence with SWAP.2. According to the analysis of the difference of the perimetry index (MD and PSD)in three groups inspected by SAP, we deem that SAP can distinguish normal person and POAG, and this is a valid method to diagnose earlier POAG.. But comparing the normal person and the suspect glaucoma, this method does not work. Analyzing the difference index in three groups inspected by SWAP, we also deem that SWAP can distinguish normal person and POAG, and this is also a valid method to diagnose earlier POAG. At the same time the SWAP can distinguish the normal group from suspect glaucoma group. SWAP can inspect the difference while SAP can't. It is very significant to the diagnosis and cure for earlier POAG.. Although SAP and SWAP can distinguish the normal person from glaucoma and are valid methods to diagnose earlier POAG, the SWAP is more delicate than SAP, can distinguish the normal person from POAG earlier, and then diagnose POAG earlier.3.After analyzing the result of GHT in earlier POAG group inspected by SAP and SWAP, we got some clues: In earlier POAG group ( 32 eyes), the abnormal results of 19 eyes were inspected by SAP ,and 17 eyes among them could also be inspected by SWAP, the sensitivity ratio was 59.38%(19/32). In them the abnormal result inspected by SAP can also be inspected by SWAP. .Meanwhile, SWAP can find visual field loss that SAP can't inspect. 27eyes were abnormal by SWAP ,the sensitivity ratio was 84.38%(27/32), the abnormal result of 10 eyes was inspected by SWAP while SAP can not . The sensitivity of SWAP is higher than SAP, and there is significant difference between the result of GHT by SAP and SWAP. So we can conclude: The sensitivity of SWAP is higher than SAP in inspecting and diagnosing earlier visual field loss of POAG.. Even if the result by SAP is normal, SWAP can inspect POAG visual field loss.4.we compare the visual field loss of the suspect glaucoma group and early POAG group inspected by SAP and SWAP respectively. The average relative defect points inspected by SWAP are more than that by SAP in both the suspect glaucoma group and early POAG group. To compare the extent of loss, SWAP have more superiority than SAP, SWAP can inspect more width than SAP. In summarize:(1) SAP and SWAP is consistent in the inspecting of POAG. .Both SAP and SWAP can distinguish normal person from POAG, and they are both valid method to early diagnose POAG . (2) The sensitivity of SWAP is higher than SAP in inspecting visual field loss in early POAG., when the visual result by SAP is normal, SWAP can inspect earlier abnormal visual result comparing with SAP. (3) SWAP can inspect deeper and wider visual field loss comparing with SAP.