Publisher: Journal of Glaucoma 33(3):p 162-167, March 2024

Authors: Dario Romano, MD, Francesco Oddone, PhD, Giovanni Montesano, PhD, Paolo Fogagnolo, MD, Benedetta Colizzi, MD, Lucia Tanga, MD, Sara Giammaria, MD, Chiara Rui, MSc, and Luca M. Rossetti, MD

Comparison Between 24-2 ZEST and 24-2 ZEST FAST Strategies in Glaucoma and Ocular Hypertension Using a Fundus Perimeter


Using a Compass (CMP) (CMP, Centervue, Padova, Italy) fundus perimeter, Zippy Estimation by Sequential Testing (ZEST) FAST strategy showed a significant reduction in examination time compared with ZEST, with good agreement in the quantification of perimetric damage.


The aim of this study was to compare the test duration of ZEST strategy with ZEST FAST and to evaluate the test-retest variability of ZEST FAST strategy on patients with glaucoma and ocular hypertension.

Patients and Methods:

This was a multicenter retrospective study. We analyzed 1 eye of 60 subjects: 30 glaucoma patients and 30 patients with ocular hypertension. For each eye we analyzed, 3 visual field examinations were performed with Compass 24-2 grid: 1 test performed with ZEST strategy and 2 tests performed with ZEST FAST. Mean examination time and mean sensitivity between the 2 strategies were computed. ZEST FAST test-retest variability was examined.


In the ocular hypertension cohort, test time was 223±29 seconds with ZEST FAST and 362±48 seconds with ZEST (38% reduction, P< 0.001). In glaucoma patients, it was respectively 265±62 and 386±78 seconds (31% reduction using ZEST FAST, P<0.001). The difference in mean sensitivity between the 2 strategies was −0.24±1.30 dB for ocular hypertension and −0.14±1.08 dB for glaucoma. The mean difference in mean sensitivity between the first and the second test with ZEST FAST strategy was 0.2 ±0.8 dB for patients with ocular hypertension and 0.24±0.96 dB for glaucoma patients.


ZEST FAST thresholding provides similar results to ZEST with a significantly reduced examination time. Key Words: glaucoma, ocular hypertension, visual field, fundus perimetry, fundus tracking