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M.M. Fahim, A. Toor, A. Sleem, S. Bernardo, L.A. Polikoff, D. Gill, J.B. Serle; Comparison of Scanning Laser Tomography and Humphrey Visual Field Analysis to Determine Progression in Glaucoma Patients . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3351.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:To compare optic disc examinations using the Heidelberg Retinal Tomograph (HRT) with visual field examinations using Humphrey Visual Field (HVF) analysis in detecting progression of glaucoma patients. Methods:This was a retrospective cross–sectional study which included patients who had at least 3 HRTs and at least 3 HVFs over a follow–up of at least 5 years. Each HRT exam assessed optic disc structure from a mean of 3 images analyzed using HRT version 2.01 software. The optic disc was classified as showing progression if the Moorfields Regression Analysis (MRA) showed a change from normal to borderline or from borderline to outside normal limits on at least 2 HRT exams. Humphrey Visual field progression was defined as an increase of at least 2 DB in the pattern standard deviation (PSD) over the follow up period. The number of patients who progressed on HRTs, HVFs, or both exams was determined. Results:From the 1025 patients in the HRT database 180 patients had at least 3 HVFs (mean + SD) (14.2 + 4.7) and 3 HRTs (6.7 ± 2.3) over at least 5 years. 306 eyes of 180 patients were included in the analysis. Of these, 57 patients were glaucoma suspects or OHT, 75 had POAG or LTG, and 48 had other glaucoma types. Progression was detected in 90 eyes by HRT, in 48 eyes by HVF, and in 10 eyes by both techniques. 26% of eyes progressed on HRT, 15% progressed on HVF analysis, and 3% progressed on both HRT and HVF analysis. Conclusion:In a database of glaucoma suspects and patients, HRT identified a higher number of patients progressing as compared to HVF analysis. The number of patients progressing on both HRT and HVF was small. This may be due in part to the definitions chosen for progression or may suggest that structural disc changes detected by HRT may more commonly precede functional progression detected by HVF exams.
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