Purpose: To compare the glaucoma diagnostic capability and other parameters of Kowa AP-7000™ (AP-7000) and Humphrey Field Analyzer (HFA).
Methods: Sixty-seven eyes of 67 healthy subjects (healthy group) and 56 eyes of 56 subjects with glaucomatous structural abnormalities (glaucomatous group) underwent visual field testing using the HFA 24-2 and AP-7000 (quick 1, threshold central 2). We evaluated the sensitivity and specificity of each perimeter to detect glaucomatous visual field defects, and diagnostic agreement was analyzed using the kappa coefficient. Agreement between AP-7000 and HFA parameters was also evaluated using Spearman rank-order correlation and a Bland-Altman plot.
Results: Sensitivity and specificity of HFA and AP-7000 were 80.4% and 85.7% and 79.1 and 77.6%, respectively. The kappa coefficient of diagnostic agreement was 0.64 (p<0.001) overall and 0.25 (p=0.039) in the healthy group. In the glaucomatous group, the kappa coefficient was 0.54 (p=0.007) among subjects with mean deviation (MD) greater than or equal to-3 dB and 1.00 (p<0.001) among subjects with MD of less than-3 dB. Although there were strong correlations between AP-7000 and HFA parameters, such as MD (rs=0.86, p<0.001) and visual field index (rs=0.80, p<0.001), the Bland-Altman analyses of these parameters showed fixed and proportional biases.
Conclusions: Although the AP-7000 and HFA parameters showed strong correlations, the kappa coefficient for diagnostic agreement was lower in the healthy group and the early glaucomatous group. This study showed that the AP-7000 tended to underestimate severity in cases of more severe visual field defects more than HFA.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 121: 915-922, 2017.