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M. V. Mandalaywala, R. Honkanen, S. Wu, B. Nemesure, L. Hyman, A. Hennis, M. C. Leske, Barbados Eye Studies Group; Comparison of Two Visual Field Staging Systems in Glaucoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1103.
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© ARVO (1962-2015); The Authors (2016-present)
Visual field (VF) analysis remains a mainstay for determining severity of glaucoma and progression of disease. Several VF staging systems have been developed. An ideal staging system would have characteristics including: ease of calculation, good reliability and reproducibility, and clinical relevance when evaluating both individuals and large groups. The Advanced Glaucoma Intervention Study staging system (AGIS-SS) and the Bascom Palmer Glaucoma Staging System (BP-GSS) have been described previously.The purpose of this study was to evaluate the performance of the AGIS-SS and BP-GSS in a population-based sample of persons with open angle glaucoma (OAG). The evaluation included participants in the Barbados Eye Studies with OAG at baseline and Humphrey 30-2 VF data from the baseline and 9-year follow-up examinations. All participants were of African descent.
A program that calculates AGIS-SS and BP-GSS scores was written in Filemaker Pro 8. Total deviation data were entered manually into the database program, while other field data were imported from an Excel file containing the information.
175 visual fields from 61 BESs participants were examined. The mean AGIS-SS score for all fields at baseline and follow-up was 8.7+ 6.5 (SD). The mean BP-GSS score for the same group was 2.0+0.5 (SD). Graphing AGIS-SS versus BP-GSS scores showed good correlation with r = 0.75. For BP-GSS scores of 0,1,2,3 and 4, the mean AGIS-SS scores were 0.5 + 0.7, 3.9+ 4.1, 9.4 + 4.1, 13.2 + 4.7, and 16.7 + 4.8, respectively. Mean scores at baseline and follow-up were 7.2 and 10.2, respectively, for AGIS-SS (p=0.003), and 1.8 and 2.3, respectively, for BP-GSS (p=0.003).
Compared to the AGIS-SS, the BP-GSS provides similar ability to stage glaucoma and detect VF progression, yet has benefits of easier calculation and is more adaptable to computerized analysis than is the AGIS-SS system. These results have implications for future studies of glaucoma staging and of incidence/progression.
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