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F. J. Munoz Negrete, F. Arnalich-Montiel, P. Casas-LLera, G. Rebolleda; Performance of Glaucoma Progression Analysis (GPA) Software in a Glaucoma Population. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1093.
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To test the performance of the Glaucoma Progression Analysis (GPA) software in the Humphrey Field Analyzer in ruling out glaucomatous progressive visual field loss in routine ophthalmic clinical practice.
Retrospective cross-sectional study. One hundred and twenty-nine eyes of 99 patients with glaucoma with at least five reliablevisual fields were included. Patients had an average follow-up of 5 years.
The prevalence of progressive visual field damage was 28% with GPA analysis and 27% with clinical criteria analysis. The kappa index of agreement between these two approaches was 0.83 if two consecutive visual fields with progressing damage were needed to confirm true progression. If three consecutive visual fields with progressing damage were needed to confirm progression, agreement decreased to 0.58. The GPA performance showed a sensitivity and specificity of 89% and 95%, respectively, and a positive likelihood ratio of 17 if based on the criterion requiring two consecutive visual fields with progressing damage. The performance was poorer if based on the criterion requiring three consecutive visual fields with progressing damage.
GPA identification of progression of visual field damage is highly correlated with a thorough clinical assessment of the visual fields and could be used routinely in normal clinical practice to screen for progressing glaucoma damage with high specificity, a very strong positive likelihood ratio, and good sensitivity and negative likelihood ratio.
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