May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Comparison of the Rate of Glaucoma Progression by Stage Using Structural and Functional Testing
Author Affiliations & Notes
  • S. Liang
    Ophthalmology, Mount Sinai Hospital, New York, New York
  • A. Ostrovsky
    Ophthalmology, Mount Sinai Hospital, New York, New York
  • J. Danias
    Ophthalmology, Mount Sinai Hospital, New York, New York
  • A. Prywes
    Glaucoma Consultants of Long Island, Bethpage, New York
  • C. Marcus
    Glaucoma Consultants of Long Island, Bethpage, New York
  • R. Rothman
    Glaucoma Consultants of Long Island, Bethpage, New York
  • C. Horsham
    Ophthalmology, Mount Sinai Hospital, New York, New York
  • D. Savitsky
    Ophthalmology, Mount Sinai Hospital, New York, New York
  • J. B. Serle
    Ophthalmology, Mount Sinai Hospital, New York, New York
    Glaucoma Consultants of Long Island, Bethpage, New York
  • Footnotes
    Commercial Relationships  S. Liang, None; A. Ostrovsky, None; J. Danias, None; A. Prywes, None; C. Marcus, None; R. Rothman, None; C. Horsham, None; D. Savitsky, None; J.B. Serle, None.
  • Footnotes
    Support  NEI EY 01867, RPB, Fund for Ophthalmic Knowledge, Inc., NY, NY
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 737. doi:https://doi.org/
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      S. Liang, A. Ostrovsky, J. Danias, A. Prywes, C. Marcus, R. Rothman, C. Horsham, D. Savitsky, J. B. Serle; Comparison of the Rate of Glaucoma Progression by Stage Using Structural and Functional Testing. Invest. Ophthalmol. Vis. Sci. 2008;49(13):737. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To compare proportion of eyes progressing by various structural and functional parameters in various stages of disease.

Methods: : Charts of 201 patients with the diagnosis of glaucoma or glaucoma suspect followed at 5 glaucoma practices for at least 3 years with a minimum of 5 HVF (24-2 or 30-2) tests and 3 HRT II examinations were reviewed. For each patient, the eye with the higher Glaucoma Staging System (GSS) score was used in the analysis. HVF progression was assessed by Glaucoma Progression Analysis (GPA) and linear regression analysis of mean deviation (MD). HRT-II progression was assessed by Moorfields Regression Analysis (MRA) and at least a 10% change in 3 or more of 5 major stereometric analysis (SMA) parameters. Disease progression according to physician’s clinical impression was recorded. For binary parameters a goodness of fit Chi2 test was used to compare the number of patients who progressed in stage 0, stage 1-2, and stage 3-4. MD change per year was compared using ANOVA.

Results: : Mean age of patients was 69±14 yrs. 70 patients had stage 0 disease, 69 had stage 1-2 disease, and 62 had stage 3-4 disease. Mean follow-up was 6.1±2.3 yrs (range 3.0 to 14.7 yrs). The proportion of eyes showing progression by GPA, SMA and MRA was the same in the 3 groups (p>0.05). However, the proportion of eyes showing progression by clinical impression was significantly lower in eyes with stage 0 disease (p=0.02). Average yearly MD change in all eyes (n=201) was -0.32 ± 0.83 dB/yr with progressively higher rates in patients with late stages of glaucoma (-0.04 ± 0.37 dB/yr in stage 0, -0.42 ± 0.58 dB/yr in stage 1-2, and -0.53 ± 1.26 dB/yr in stage 3-4, p=0.001). Assuming that a change in MD of more than 1DB/yr is pathologic, the proportion of eyes progressing was lower among stage 0 eyes (p=0.0004).

Conclusions: : Patients with advanced disease were more likely to deteriorate than those with early disease according to one of the measures of function analyzed, MD, and according to physician’s clinical impression. Structural analysis and GPA did not show differences in the rates of progression by stage of glaucoma.

Keywords: visual fields • optic nerve • perimetry 
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