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Sujata P. Prabhu, Robert Honkanen, Suh-Yuh Wu, Lorena LoVerde, Kevin Lai, Barbara Nemesure, Leslie Hyman, Anselm Hennis, M. Cristina Leske; Comparison of the 9-year Progression of Visual Field Defects in the Barbados Eye Studies using 3 Scoring Systems. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5021.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate changes in visual field (VF) scores of participants in the Barbados Eye Studies (BESs) after 9 years of follow up using 3 different classification systems.
BESs participants with open angle glaucoma (OAG) at baseline who had Humphrey 30-2 visual field (VF) data at both the initial and 9 year follow up exams were included. VFs of eyes were scored using the Advanced Glaucoma Intervention Study (AGIS) method, the Glaucoma Staging System described by Brussini (BR), and the Bascom Palmer Glaucoma Scoring System (BP). VF Changes were categorized as: Definitely Worse, Probably Worse, Stable, Probably Improved, or Definitely Improved. Definitely Worse (Improved) was defined as an increased (decreased) score of 8 or more with AGIS or an increase (decrease) of at least 2 stages with BR or BP. Probably Worse (Improved) was defined as an increase (decrease) of 4-7 points in AGIS or worsening (improvement) of 1 stage in BR and BP systems. Stable was defined as a change of 3 or fewer points with AGIS and no change with BR and BP systems. Agreement among methods was evaluated by Kappa statistics.
91 eyes of 49 participants had visual fields at baseline and 9 year follow up. Mean age at baseline was 61 years; 51% were female. Mean (SD) VF scores at baseline were 7.7 (6.0) for AGIS, 3.0 (1.4) for BR, and 1.7 (1.1) for BP. After 9 years, VF scores were Definitely Worse for 21%, 15%, and 15% for AGIS, BR, and BP, respectively. Percentages for the same respective groups in the other categories were: Possibly Worse (15%, 24%, 29%), Stable (51%, 44%, 37%), Possibly Improved (9%, 10%, 14%), and Definitely Improved (4%, 7%, 4%). There was good agreement between AGIS and BR with a weighted Kappa (95% confidence limit) of 0.74 (0.64 -0.84) followed by 0.58 (0.45 - 0.70) for BR vs BP, and 0.47 (0.33-0.60) for AGIS vs BP.
In this study, VFs were classified as Definitely or Probably worse in 36%, 39%, and 44% of eyes for the AGIS, BR and BP scoring systems, respectively. The highest agreement was found between AGIS and BR, while AGIS and BP had the least agreement.
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