Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field

Abstract

Purpose : To detect glaucoma progression using optical coherence tomography (OCT) and visual fields (VF).

Methods : Subjects with more than 5 follow-up visits in the multi-center Advanced Imaging for Glaucoma study were analyzed. Fourier-domain optical coherence tomography (OCT) was used to map the thickness of peripapillary retinal nerve fiber layer (NFL) and macular ganglion cell complex (GCC). OCT-based progression detection was defined as a significant (p<0.05) negative trend for either average NFL or average GCC using ordinary least square regression analysis. VF progression was detected if either the Guided Progression Analysis or Visual Field Index (VFI) trend reached significance.

Results : The analysis included 417 glaucoma suspect and pre-perimetric glaucoma (GS/PPG) eyes and 377 perimetric glaucoma (PG) eyes. Progression was detected in 38.9% of eyes in the GS/PPG group with OCT compared to 18.7% with VF (P<0.001). In the PG group, OCT had significantly higher detection rate, compared to VF in early PG (49.7% vs. 32.0%, p=0.02), while VF had nonsignificant higher detection rates in moderate and advanced PG. In advanced PG, the rate of NFL thinning declined, but GCC thinning rate remained relatively steady and allowed good progression detection even in advanced disease. The rate of false positive progression detection in permutated series was over 10% for VFI in both GS/PPG and PG group, while under 7% for both GCC and NFL.

Conclusions : OCT is more sensitive than VF in progression detection in early glaucoma. While the value of NFL declines in advanced glaucoma, GCC remains a good progression detector from early to advanced stages.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.