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Daisuke Shiba, Eri Hirano, Sayaka Adachi, Kenya Yuki, Kazuo Tsubota; Comparison of reproducibility in glaucoma severity staging by structural measurement and functional test. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5810.
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© ARVO (1962-2015); The Authors (2016-present)
A precise severity staging method for evaluating glaucomatous optic neuropathy (GON) has an advantage to evaluate GON properly. The objective of the present study is to compare reproducibility in staging GON between macular ganglion cell complex thickness (GCCT) with spectral-domain optical coherence tomography (SD-OCT) and visual field sensitivity (VFS) with standard automated primetry (SAP).
In this prospective study, we included glaucoma patients with visual field defect above -18dB of mean deviation value. Eyes with cataract or any other ocular abnormality or history of intraocular surgery except successful glaucoma surgery were excluded. The included patients underwent SAP by Humphry field analyzer with central 30-2 program and GCCT measurement by SD-OCT (Nidek; RS-3000 Advance) with macular scan. The same examinations were repeated at the next visit for less than two months. We used mean GCCTs in superior semicircle (SSC) with the radius of 3mm and inferior semicircle (ISC) with the same radius as structural measures. The center of SSC or ISC was positioned at the fovea. Meanwhile, mean VFSs of superior hemi-field (SHF) and inferior hemi-field (IHF) were adopted as functional measures. Eyes were classified into 10 stages based on the deciles of each measure. We adopted Cohen’s weighted kappa statistic as a measure of the inter-visit agreement in glaucoma staging.
60 eyes of 60 patients were included in this study. The mean first / second GCCTs were 84.1±10.4µm / 83.9±10.5µm in SSC and 74.6±1.5µm / 74.6±1.51µm in ISC. Mean VFSes at first / second visit was 25.6±5.6dB / 25.4±5.6dB in IHF, 22.9±7.5dB / 22.9±7.1dB in SHF. Weighted kappa values [95%CI] with SD-OCT were 0.982[0.974, 0.990] and 0.987[0.981, 0.993] in SSC and ISC, whereas Kappa values with SAP were 0.683[0.279, 1.09] in IHF and 0.968[0.959, 0.977] in SHF.
Staging by structural measures had a higher reproducibility than by functional measures in this study population with glaucoma.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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