Should We Abandon Standard Automated Perimetry (SAP) for Frequency Doubling Technology?

April 19, 2009

We are taught that Standard Automated Perimetry is the standard when diagnosing glaucoma, but research has been pretty unequivocal in suggesting that Frequency Doubling Technology (FDT) will pick up glaucoma much earlier. Furthermore, since structural changes precede functional by several years, technologies like HRT and OCT also pick up glaucoma earlier. Lately, I have become so frustrated with SAP, that I am slowly abandoning it and relying on FDT and HRT. I have had enough with the high false negatives, fixation losses and the need to repeat SAP several times before I can get a reliable indication. But in the back of mind, I wonder if I could prevail in court if I don’t get SAP on my glaucoma patient. On the other hand, there was a time when tangent screen and Golmann were the standards- why can’t I make the argument in court that SAP is no longer the standard? Does anyone know of any case law that would support such a contention?




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