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Elena Bitrian, Dennis Mock, Simon K. Law, Kouros Nouri-Madhavi, Anne L. Coleman, Joseph Caprioli; Detection of Glaucoma Progression by Optic Disc Photographs Evaluation and Fast Component of the Visual Field Rate of Progression. Invest. Ophthalmol. Vis. Sci. 2012;53(14):226.
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To investigate the ability to detect progression of glaucoma by expert analysis of optic disc photos and visual field (VF) analysis of the fast component rate of progression.
Eyes with treated early and moderate open-angle glaucoma, a minimum of 6 years of follow-up and 6 reliable visual fields were included. Stereoscopic optic disc photograph series were evaluated by 3 experienced glaucoma specialists and graded from 1 to 5, from no progression to definite progression. The average score was recorded. The fast component of visual fields was calculated as the exponential rate of progression or decay for each point location and partitioning the rates into its fast and slow components for each eye. The fast component was then weighted by the significance of the fit in every location. (Caprioli et al, IOVS 2011 Jul1;52(7):4765-73). Demographic characteristics, visual acuity (VA) and intraocular pressure (IOP) for the follow-up were recorded.
A total of 277 eyes were included. Mean age was 61.49 ± 10.84 years, 55.3 % of patients were females, 70.1% Caucasian, 4.1% African American, 5.6 % Hispanic and 15,7 % Asian. Follow-up was 9.14 ± 2.02 years. The average IOP was 14.36 ± 3.49 mmHg and IOP fluctuation was 2.29 ± 1.09 mmHg. A total of 9.4 % eyes were considered to definitely have progression per optic disc photos analysis. The average weighted fast rate of decay was -0.26 ± 0.37 dB/year. Eyes were divided in two groups: no progression (optic disc score 1-2, n= 26 eyes) or progression (score 4-5, n= 176 eyes). Score value of 3 were excluded (n=75). There were no significant statistical differences between progression and no progression groups in age (61.64 ± 11.37 and 60.17 ± 8.33, respectively, p=0.526)), IOP (14.66 ±3.76 and 13.93 ± 2.79, p=0.342)), fluctuation of IOP (2.22 ± 1.08 mmHg and 2.47 ± 1.32 mmHg, p=0.282)) or average VA (0.81 ± 0.16 and 0.8 ± 0.11, p=0.937)). A statistically significant difference existed between the weighted fast component of VF rates of progression, which were 14% in the non progressing group and 44% in the progressing group (p=0.02).
The weighted fast component of the visual field showed a significantly faster rate of decay in the group of glaucomatous eyes whose disc were worsening, as determined per optic disc photos examination. With these techniques in this group of patients with a moderate stage of disease, there is a correlation between disc change and VF change.
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