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K. S. Kishor, D. S. Grewal, M. Sehi, D. S. Greenfield, Advanced Imaging in Glaucoma Study Group; Longitudinal Detection of Progressive Optic Disc Change in Glaucoma Suspects and Glaucomatous Eyes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4017.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the rate of progressive optic disc change in progressing versus stable eyes defined using 3 methods for detecting visual field progression.
Glaucoma suspect and glaucomatous eyes with ≥3 years of follow-up were prospectively enrolled. All eyes underwent standard automated perimetry (SAP) and Heidelberg Retina Tomography (HRT3, Heidelberg Engineering, Germany) every 6 months. The annual rate of change in rim area (RA), rim volume (RV), vertical cup-disc ratio (CDR) and cup shape measure (CSM) was determined for each eye. SAP progression was determined using Early Manifest Glaucoma Trial (EMGT) criteria defined as significant change in ≥3 locations on 3 consecutive SAP exams, significant negative visual field index (VFI) slope at p<0.05 and pointwise linear regression analysis of SAP sensitivity using ProgressorTM defined as a loss of -1dB/year at p<0.01 confirmed on two consecutive examinations.
Fifty-eight glaucoma suspect and 46 glaucomatous eyes were enrolled (mean follow-up 44.9 ± 5.4 months). Three eyes (2.9%) progressed using EMGT criteria, 21 (20.2%) eyes using ProgressorTM, and 12 eyes (11.5%) using VFI. At baseline the mean RA (mm2), RV (mm3), CDR and CSM in progressing and stable eyes were similar (p>0.05). There was a significantly greater mean rate of decline in RA (mm2/yr) in progressing vs stable eyes judged using EMGT (-0.04±0.02 vs -0.001±0.03, p=0.02), VFI (-0.16±0.04 vs -0.003±0.02, p=0.04), and ProgressorTM (-0.23±0.02 vs 0.003±0.02, p<0.001). There was a significant greater mean rate of decline in RV (mm3/yr) in progressing vs stable eyes judged using EMGT (-0.01±0.004 vs -0.001±0.02, p=0.008), VFI (-0.02±0.02 vs 0.005±0.01, p=0.002) and ProgressorTM (-0.01±0.02 vs 0.001±0.01, p=0.003).
Despite differences in criteria used to judge functional progression, eyes with SAP progression have significantly greater neuroretinal rim loss measured using HRT compared with stable eyes.
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