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Robert Laemmer, Folkert K. Horn, Anselm G. Jünemann, Friedrich E. Kruse, Christian Y. Mardin; Trend- and event-based Analysis of Visual Field Progression in Glaucoma Patients with single und recurrent Optic Disc Hemorrhages. Invest. Ophthalmol. Vis. Sci. 2012;53(14):224.
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To investigate trend- and event-based approaches for visual field analysis in patients with open angle glaucoma and single (group 1) or repeated (group 2) optic disc hemorrhages (ODH) during long-term follow-up.
All investigated patients were members of an ongoing observational cohort study (Erlangen Glaucoma Registry: NTC00494923) and annually received a detailed standardized glaucoma examination including standard automated perimetry (Octopus 900, Interzeag AG, Schlieren, Switzerland) and optic disc photographes (Zeiss telecentric fundus camera, Oberkochen, Germany). Fifty one patients with perimetric glaucoma and ODH were included in the study. Mean follow-up was 10.3±4.0 years. Global and sector data were analysed. Trend- and event-based approaches for visual field analysis were evaluated and compared to morphologic optic disc changes defined by masked comparative evaluation of optic disc photographs.
Calculated mean visual field change was -0.10 dB/year before occurrence of the first ODH and -0.39 dB/year after ODH in group 1 compared to 0.15 dB/year before and -0.51 dB/year after occurrence of the first ODH in group 2. Kaplan-Meier-Analysis demonstrated a faster rate of progression in patients with recurrent ODH if sector data were evaluated. In group 1 after 3, 5 and 10 years 50, 67 and 85 % of patients had significant visual field progression compared to 65, 78, 89 % in group 2. Rate of detected neuroretinal rim loss by masked comparative evaluation of optic disc photographs was 34, 47 and 75 % after 3, 5 and 10 years in group 1 and 35, 70 and 90 % in group 2.
Glaucoma patients with recurrent ODH demonstrated faster visual field deterioration. Both trend- and event-based analysis are useful to detect visual field change. Evaluation of sector data was superior to global parameters and comparable or even more sensitive in the early follow-up period compared to results of masked comparative evaluation of optic disc photographs.
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