The prevalence of glaucomatous defects with short-wavelength automated perimetry in patients with elevated intraocular pressures.

PURPOSE: To determine the prevalence of abnormal short-wavelength automated perimetry (SWAP) visual fields in subjects with elevated intraocular pressures (IOP) for 7 existing definitions of mild glaucomatous loss, and to explore the agreement between them.

PATIENTS AND METHODS: Seven hundred and forty-four eyes of 379 subjects with an IOP > or = 22 and < or = 32 mm Hg and normal visual fields with standard automated perimetry (SAP) were tested with SWAP on 3 separate occasions, of which the second and third visual field were used for analysis. The appearance of the optic disc was not an eligibility criterion. We determined the number of visual fields classified as abnormal on 2 successive occasions by 7 existing definitions. In addition, we explored the agreement between the various definitions.

RESULTS: The proportion of eyes with a glaucomatous visual field with SWAP ranged between 0% and 9.9%, depending on the criterion used to define abnormality. A pairwise comparison of the various definitions showed that several definitions classified different eyes as having an abnormal field.

CONCLUSIONS: We found a large variation in the proportion of visual fields with SWAP classified as abnormal by the various definitions. More importantly, various definitions identified different individuals to have an abnormal field with SWAP. Therefore, the diagnostic accuracy and clinical significance of all definitions must be determined before SWAP is used in routine clinical care.