April 2011
Volume 52, Issue 14
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ARVO Annual Meeting Abstract  |   April 2011
Clinical Significance of Optic Disc Progression by Topographic Change Analysis Maps in Glaucoma and Ocular Hypertension: An 8-year Follow-up Study
Dimitrios Kourkoutas; Yvonne M. Buys; John G. Flanagan; Nicolaos Karamaounas; Gerasimos Georgopoulos; Evaggelos Iliakis; Michael Moschos; Graham E. Trope
Author Affiliations & Notes
  • Dimitrios Kourkoutas
    Glaucoma, 401 Hellenic Army General Hospital, Athens, Greece
  • Yvonne M. Buys
    Dept of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • John G. Flanagan
    Dept of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Nicolaos Karamaounas
    Ophthalmology, 417 Army Shared Fund Hospital, Athens, Greece
  • Gerasimos Georgopoulos
    1st Department of Ophthalmology, Medical School, University of Athens, Athens, Greece
  • Evaggelos Iliakis
    1st Department of Ophthalmology, Medical School, University of Athens, Athens, Greece
  • Michael Moschos
    1st Department of Ophthalmology, Medical School, University of Athens, Athens, Greece
  • Graham E. Trope
    Dept of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada
  • Footnotes
    Commercial Relationships  Dimitrios Kourkoutas, None; Yvonne M. Buys, None; John G. Flanagan, Heidelberg Engineering (C); Nicolaos Karamaounas, None; Gerasimos Georgopoulos, None; Evaggelos Iliakis, None; Michael Moschos, None; Graham E. Trope, None
  • Footnotes
    Support  Glaucoma Research Society of Canada Grant
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4135. doi:
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      Dimitrios Kourkoutas, Yvonne M. Buys, John G. Flanagan, Nicolaos Karamaounas, Gerasimos Georgopoulos, Evaggelos Iliakis, Michael Moschos, Graham E. Trope; Clinical Significance of Optic Disc Progression by Topographic Change Analysis Maps in Glaucoma and Ocular Hypertension: An 8-year Follow-up Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4135.

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Abstract
 
Purpose:
 

To prospectively determine how well the Heidelberg Retina Tomograph (HRT) Topographic Change Analysis (TCA) maps are able to predict the development of optic nerve head (ONH) and/or visual field (VF) change, in clinically stable (at enrolment) patients with OHT and glaucoma.

 
Methods:
 

Following a retrospective study, 78 clinically stable eyes (stable on ONH stereophotographs and VFs) of 78 patients were enrolled in a prospective study. Study eyes were classified as TCA-progressed or TCA-stable based on the TCA results. All patients underwent testing with HRT3, VF and ONH stereophotographs at yearly intervals. Progression was determined by masked assessment of optic disc photographs and by glaucoma progression analysis (GPA) on the VF.

 
Results:
 

The median (IQR) total HRT follow-up time was 8.0 (7.2-9.0) years, which included a median retrospective and prospective follow-up of 4.2 (1.3-8.7) and 3.9 (3.5-4.6) years respectively. VF and/or photographic change occurred in 5 of 17 TCA-stable patients and in 11 of 61 TCA-progressed patients. 10 patients had photographic changes only, 3 patients had VF changes only and 3 patients had photographic and VF changes. Using the Kaplan-Meier method, the mean time for VF and/or ONH progression from recruitment was shorter in TCA-progressed patients (4.9 years, 95% CI: 4.54-5.23 years) than in TCA-stable patients (5.3 years, 95% CI: 4.35-6.26 years). This result did not reach statistical significance (log rank=0.925). The TCA map had a positive predictive value (PPV) of 18.03% and a negative predictive value (NPV) of 70.58%.

 
Conclusions:
 

In this cohort, by using our study criteria, TCA progression was documented in 61 of 78 subjects but confirmed clinically in only 16 subjects. It is possible that TCA ONH change is associated with earlier clinical glaucoma progression, but it appears that HRT TCA is overly sensitive with poor specificity.

 
Clinical Trial:
 

http://www.clinicaltrials.gov NCT00424996

 
Keywords: optic nerve • imaging/image analysis: clinical 
© 2011, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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