Short-wavelength automated perimetry and standard perimetry in the detection of progressive optic disc cupping

Objective: To compare progression in short-wavelength automated perimetry ( SWAP) and white-on-white (standard) perimetry in eyes with progressive glau comatous changes of the optic disc detected by serial stereophotographs. Methods: Forty-seven glaucoma patients with at least 2 disc stereophotograp hs more than 2 years apart, along with standard perimetry and SWAP examinat ions within 6 months of each disc photo of the same eye, were included in t he study. The mean follow-up time was 4.1 years (range, 2.0-8.9 years). Bas eline and follow-up stereophotographs were then graded and compared for the presence of progression. Progression in standard perimetry and SWAP, using the Advanced Glaucoma Intervention Study scoring system and a clinical sco ring system, was compared between eyes with progressive change on stereopho tographs and those without. Results: Twenty-two of 47 eyes showed progressive change by stereophotograp hs. There was a statistically significant difference in the mean change in Advanced Glaucoma Intervention Study scores for both standard perimetry (P< .004) and SWAP (P<.001) between the progressed and nonprogressed groups. Th e sensitivity, specificity, and area under the receiver operator characteri stic curve were higher using SWAP than standard perimetry when evaluated by either algorithm. This was statistically significant only in the area unde r the receiver operator characteristic curve for the Advanced Glaucoma Inte rvention Study scoring system (P=.04). Conclusions: Short-wavelength automated perimetry identified more patients than standard perimetry as having progressive glaucomatous changes of the o ptic disc. Compared with standard perimetry, SWAP may improve the detection of progressive glaucoma.