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T. A. Williams, M. A. Roberts, M. W. Austin; Comparison of Clinical Interpretation Versus Progressor® Software in Visual Field Analysis in Glaucoma Follow Up. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4001.
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To compare clinical judgement of visual field (VF) progression with that of PROGRESSOR® analyser (pointwise linear regression analysis) in the detection of glaucomatous VF progression in a routine Ophthalmology clinical setting.
A consecutive series of patients performing routine VFs for glaucoma (Humphries VF analyser 30-2) was prospectively identified. Exclusions- non glaucomatous indications for VF; ocular pathology preventing accurate VF performance; total VF <3/eye. The examining Ophthalmologist’s judgement of VF progression by visual inspection of serial VF printouts at the next outpatient review (progression or stable), was retrospectively reviewed and compared with PROGRESSOR® analysis at the same time point (progression (≤3 non-edge progressing points) or stable). One eye was randomly selected/patient for analysis.
105 eyes (105 patients) (53 males; 52 females) were included. Mean age 75 years (range 38- 91 years). POAG 54; OHT 19; NTG 9; PXFG 4; Aphakic glaucoma 1; CNAG 7; Glaucoma suspect 5; PDS 1; normal 5. Mean no of VF/eye 7 (range 3-12). Mean follow up 6.2 years17 eyes (16%) had progression identified on PROGRESSOR®. 77 eyes (73%) had a clinical judgement of VF progression documented in the clinical notes. Of these- overall 80.5% agreement between Ophthalmologist and PROGRESSOR; 27% of eyes progressing on PROGRESSOR were correctly judged as progressing by the ophthalmologist.
This study shows a fair level of agreement between clinician and PROGRESSOR for the whole group due to the high proportion of stable eyes correctly categorised by the Ophthalmologist. Only a small proportion of progressing eyes were correctly identified as progressing by the clinician. .
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