May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Visual field and optic disk progression in a longitudinal study of open–angle glaucoma.
Author Affiliations & Notes
  • P.H. Artes
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
  • M.T. Nicolela
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
  • R.P. LeBlanc
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
  • B.C. Chauhan
    Ophthalmology and Visual Sciences, Dalhousie University, Halifax, NS, Canada
  • Footnotes
    Commercial Relationships  P.H. Artes, None; M.T. Nicolela, Heidelberg Engineering F, R; R.P. LeBlanc, Heidelberg Engineering R; B.C. Chauhan, Heidelberg Engineering F.
  • Footnotes
    Support  NSHRF–MED 727 (PHA), CIHR grant MOP–11357 (BCC)
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 970. doi:
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      P.H. Artes, M.T. Nicolela, R.P. LeBlanc, B.C. Chauhan; Visual field and optic disk progression in a longitudinal study of open–angle glaucoma. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):970.

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

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Abstract

Abstract: : Purpose: To determine the relationship between optic disk and visual field change in a prospective study of open–angle glaucoma. Methods: Eighty–six patients with open–angle glaucoma (mean age at study entry 63, range 31 to 88 yrs) were followed for a median of 8 yrs (range, 3 to 10 yrs). One eye of each patient was examined with Standard Automated Perimetry (SAP, Humphrey Field Analyzer, full–threshold program 30–2), High–Pass Resolution Perimetry (HRP, Ophthimus perimeter) and confocal scanning laser tomography of the optic disk (Heidelberg Retina Tomograph, HRT). Progression was evaluated in 4 sectors of the optic disk (superior, inferior, temporal, nasal) and the corresponding sectors of the visual field (inferior, superior, central, temporal). The strength of the evidence for change was assessed by Spearman’s rank correlation of optic disk rim area and visual field sensitivity with follow–up time, and graded on an ordinal scale ranging from 0 (p>0.1) to 5 (p<0.001). These grades were then summed across the 4 sectors to calculate a global ‘Evidence–of–Progression’ (EOP) score for each test and each eye, ranging from 0 (no evidence of change) to 20 (strong evidence). Results: With both HFA and HRP, the progression scores were highest in the superior, central and inferior visual field sectors. A similar, though weaker, spatial predominance of progression in the inferior, superior and temporal disk sectors was observed with the HRT. Although the EOP scores of both visual field tests correlated reasonably well (Spearman’s rho, 0.63, p<0.001), there was no statistical relationship between the optic disk EOP score and the visual field EOP score either with SAP (rho=0.02, p=0.65) or HRP (rho=0.12, p=0.29). When criteria were chosen to classify an equal number of eyes as progressing (EOP scores of >6, >4 and >6 for 20, 19 and 20 progressing eyes with HFA, HRP, and HRT, respectively), 16 eyes were classified as progressing with both HFA and HRP, but only 5 eyes met the criteria with all three tests. Conclusions: Our results demonstrate the weak relationship between clinical measures of visual field and optic disk progression in glaucoma. Perhaps even longer follow–up periods than those of the present study are needed to elucidate the true relationship between optic disk and visual field change. We may also require better surrogates of functional and structural damage than those available today. At present, optic disk and visual field examinations contribute independent and largely complementary information on disease progression in glaucoma.

Keywords: perimetry • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • optic disc 
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