Event-based analysis of visual field change can miss fast glaucoma progression detected by a combined structure and function index.
Journal Article (Journal Article)
PURPOSE: To investigate the relationship between progression assessed by the visual field guided progression analysis (GPA) and rates of structural and functional change in glaucoma eyes. METHODS: This was a longitudinal observational study of 135 eyes of 97 patients with glaucoma followed for an average of 3.5 ± 0.9 years. All patients had standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) analysis with spectral domain optical coherence tomography (SDOCT), with an average of 6.8 ± 2.3 visits. A control group of healthy eyes followed longitudinally was used to estimate age-related change. Visual field progression was assessed using the Humphrey Field Analyzer GPA. Estimates of retinal ganglion cell counts from SAP and SDOCT were used to obtain a combined index of glaucomatous damage (RGC index) according to a previously described algorithm. Progression by SDOCT and the retinal ganglion cell (RGC) index were defined as statistically significant (P < 0.05) slopes of change that were also faster than age-related change estimated from healthy eyes. RESULTS: From the 135 eyes, 15 (11%) progressed by GPA, 21 (16%) progressed by SDOCT, and 31 (23%) progressed by the RGC index. Twenty-one eyes showed progression by the RGC index that was missed by the GPA. These eyes had an average rate of change in estimated RGC counts of - 28,910 cells/year, ranging from two to nine times faster than expected age-related losses. CONCLUSION: Many glaucomatous eyes that are not found to be progressing by GPA may actually have fast rates of change as detected by a combined index of structure and function.
Full Text
Duke Authors
Cited Authors
- Zhang, C; Tatham, AJ; Daga, FB; Jammal, AA; Medeiros, FA
Published Date
- July 2018
Published In
Volume / Issue
- 256 / 7
Start / End Page
- 1227 - 1234
PubMed ID
- 29623461
Electronic International Standard Serial Number (EISSN)
- 1435-702X
Digital Object Identifier (DOI)
- 10.1007/s00417-018-3963-3
Language
- eng
Conference Location
- Germany