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D. Chao, L. M. Alencar, R. N. Weinreb, L. M. Zangwill, C. Bowd, P. A. Sample, F. A. Medeiros; Scanning Laser Polarimetry Is Predictive of Development of Glaucomatous Visual Field Defects in Glaucoma Suspects. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4394.
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To determine whether Scanning Laser Polarimetry (GDx VCC) results may predict the development of visual field defects or progressive optic disc deterioration in glaucoma suspects.
This was an observational cohort study that included 270 eyes of 169 patients recruited from the longitudinal Diagnostic Innovations in Glaucoma Study (DIGS). All eligible eyes had a reliable standard automated perimetry (SAP) visual field and optic disc stereophotograph within one year of the baseline GDx. Glaucoma suspects were defined as those with normal SAP at baseline but elevated IOP (>21mmHg) and/or suspicious optic disc appearance. Glaucomatous conversion was defined as the development of 3 consecutive abnormal visual fields (defined as glaucoma hemifield test (GHT) outside normal limits and/or pattern standard deviation (PSD) with P<0.05) and/or progressive optic disc change determined by masked assessment of optic disc stereophotographs. Cox regression models were used to assess the association between baseline GDx measurements and development of glaucoma. Multivariate models were constructed to determine the predictive ability of GDx after adjusting for age, IOP, central corneal thickness (CCT) and PSD.
Twenty-nine (11%) eyes developed glaucomatous optic disc deterioration and/or visual field defects during an average follow-up time of 4.3 ± 1.1 years. In univariate analysis, all GDx parameters were significantly associated with conversion. The hazard ratios (95% CI) for NFI, average thickness, superior thickness and inferior thickness were 1.48 (1.20 to 1.83) per 10 units larger, 3.30 (2.00 to 5.46) per 10µm thinner, 2.19 (1.50 to 3.20) per 10µm thinner, and 2.02 (1.40 to 2.92) per 10µm thinner, respectively. In the multivariate models, adjusting for CCT, PSD, IOP and age, the hazard ratios were 1.36 (1.06 to 1.75), 2.09 (1.24 to 3.50), 1.68 (1.18 to 2.40) and 1.44 (0.96 to 2.17), respectively.
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