Abstract
Purpose :
To investigate which structural and functional parameters are best related to presence and severity of glaucomatous visual field damage measured on the 10-2 visual field test
Methods :
Subjects for this investigation were participating in a prospective, longitudinal glaucoma research study at the Albuquerque VA Medical Center. Inclusion required two or more reliable 24-2 and 10-2 VF tests, good quality circumpapillary retinal nerve fiber layer (RNFL) and macular thickness (MT) asymmetry scans obtained within 6 months of the VF tests, and a diagnosis of primary open-angle glaucoma (POAG), ocular hypertension (OH), or glaucoma suspect (GS). Because our objective was to identify which subjects might benefit from 10-2 VF testing, we used the subject as the unit of analysis, with worse-eye measurements used within statistical analyses. Candidate parameters were identified in regression analyses, and then incorporated into receiver operating characteristic (ROC) analyses to determine which factors or combination of factors best predicted presence and severity of 10-2 VF loss.
Results :
We studied 180 subjects (97 POAG, 54 OH, 29 GS) and found repeatable 10-2 VF loss in at least one eye of 89 subjects (49%). Multivariate regression analyses identified four parameters (presence of 24-2 VF loss, presence of abnormal 24-2 VF points within 10 degrees of fixation, global RNFL thickness, intra-eye MT asymmetry) that were independently related to presence of 10-2 VF loss (total r-squared=0.68, p<0.001). When thresholds for at least 2 of these 4 factors were exceeded, area under the ROC curve was 0.954, with 90% sensitivity and 92% specificity. In multivariate regression analysis using 10-2 VF mean defect (MD) as the dependent variable, three parameters (24-2 MD, abnormality of at least one of the four 24-2 central points, and rate of 24-2 change over time) were independently related to 10-2 MD (total r-squared=0.83, p<0.001).
Conclusions :
Presence and severity of glaucomatous 10-2 VF loss can be reliably estimated using 24-2 VF, RNFL, and MT metrics. These results may be valuable for determining which glaucoma patients will most benefit from 10-2 VF testing.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.