Can Glaucoma Progression be Predicted by HRT?

Abstract

Purpose: : To determine whether glaucoma progression can be predicted by using HRT imaging of the ONH

Methods: : 220 patients with primary or secondary glaucoma or ocular hypertension, with at least 7 years of follow-up and 3 HRT examinations in the period prior to the last 3 years of the study were included. HVFs from the same patients were also collected. One eye was analyzed per patient in random. Glaucoma progression was determined by the presence of a statistically significant negative slope in mean deviation over the last three years of the study (4 HVF exams minimum). Global HRT parameters prior to the last three years of the study, as well as change in these parameters in the prior period were correlated to outcome using logistic regression.

Results: : 69 eyes (32%) progressed while 151 (68%) remained stable. Of the baseline HRT parameters cup area, rim area, rim to disc area, rim volume, cup shape measure, horizontal cup to disc ratio, vertical cup to disc ratio and RB discriminant function correlated with outcome in univariate analysis (at least p<0.05 for each one). Percentage change of mean cup depth and height variation contour in the period prior to progression also correlated with outcome (p<0.05). In multivariate logistic regression of all significant parameters, only percent change of mean cup depth and height variation contour (p<0.02) remained significant. Using all of the above parameters 71.8% of the patients could be correctly classified.

Conclusions: : HRT imaging may be able to identify eyes at increased risk for glaucomatous progression, especially when longitudinal data are available.

Keywords: imaging/image analysis: clinical • topography • visual fields