Detection of Progression With HRT’s Topographic Change Analysis

Abstract

Purpose: : To evaluate the capabilities of the Topographic Change Analysis (TCA) of HRT to detect structural changes in glaucoma damage.

Methods: : Prospective study. Minimum follow up of 36 months. Fifty four eyes with diagnosis of glaucomatous optic neuropathy were included in this study. All subjects were examined with Humphrey perimetry (24-2 SITA standard) every six months, disc photographs and Confocal Scanning Laser Ophthalmoscopy (HRT-III, Heidelberg Engineering) once a year. Only eyes with good quality images (SD < 25µ) and reliable fields were included.

Results: : Twenty nine eyes had at least 4 HRT good quality images and 6 fields and were used for all calculations. The other 25 eyes were excluded due to insufficient quality of images or fields. Six eyes (20%) showed confirmed progression on visual fields, 5 eyes (17%) progressed according to classification changes on MRA classification, 20 eyes (68%) had a significant cluster by TCA when confirmed in two images, and 9 eyes (31%) showed a significant TCA cluster confirmed in 3 images. Finally, 5 eyes (17%) progressed in both fields and HRT.

Conclusions: : HRT detected progression in 31 to 68% of eyes after 3 years of follow up. Eighty percent of eyes with field progression showed progression on HRT.

Keywords: imaging/image analysis: clinical • clinical (human) or epidemiologic studies: systems/equipment/techniques • optic disc