Comparison of AGIS, CIGTS and EMGT Visual Field Glaucoma Progression Criteria. A Pilot Study

Abstract

Abstract: : Purpose: To conduct a pilot study comparing the performance of visual field progression criteria used in three current glaucoma trials: AGIS, CIGTS and EMGT. Methods: After randomly selecting EMGT patients, series of at least 10 visual fields from 68 patients, printed in the Overview format, were classified into one of three groups: definite progression, no progression, or otherwise, by two masked independent graders (AB and PÅ), using clinical criteria. The first 20 eyes (from 20 patients) that were classified by both graders as clearly progressing or not progressing were used in the subsequent analyses. In the non-progressing field series, the test sequence was randomized to eliminate any unrecognized visual field progression. The progression criteria from the three different clinical trials then were applied to both groups of fields. In the field series with progression, times to progression were displayed in Kaplan-Meier curves, and compared using the log rank test. Results: Among the group of 20 progressing eyes, EMGT criteria identified more eyes as progressing (20/20) than AGIS (10/20) and CIGTS (14/20) criteria. The EMGT criteria also identified progression earlier (p≤0.0001). Progression was sustained at 90.8% of subsequent visits with the EMGT criteria, at 80.5% of visits with AGIS, and at 72.0% of visits with CIGTS criteria. Among the group of 20 non-progressing eyes, EMGT criteria correctly classified all eyes as not progressing, while AGIS and CIGTS criteria incorrectly identified two and one eyes as progressing, respectively. Conclusion: In this pilot study (n=40 eyes) EMGT progression criteria identified glaucomatous progression earlier and more often than the AGIS and CIGTS criteria, without losses in specificity or sustainability.

Keywords: visual fields