Abstract
Purpose :
To compare glaucomatous VF progression identified by cluster MD trend analysis versus global MD trend analysis.
Methods :
This is a retrospective study of glaucoma eyes which had ≥ 4 reliable visual fields (VF) using the EyeSuite®software of the Octopus®900 perimeter. A G-standard dynamic strategy test program with a minimum follow-up of 1 year was used. Eyes which had cataract surgery during the interval of tests were excluded. The perimeter software grouped functionally-related VF tests points into clusters which identified progression at p<5% or p<1% levels of significance for both global and cluster trend analysis at the end of the follow up period of each patient. Progression identified in at least one cluster of the VF was flagged as a progressing eye.
Results :
20 patients had a mean age of 61.7 ± 13.54 years, 70% of the patients were females. Angle closure glaucoma comprised 50% of the eyes, while primary open angle glaucoma accounted for 30% of the eyes. Average number of VF per series was 5, with a mean follow-up period from the first to the last VF test of 3.81 ± 1.81 years. Mean baseline LogMar visual acuity was 0.06 ± 0.05 and 0.10 ± 0.05 on the final visit (p=0.09). Average baseline MD was 6.95 ± 1.84 dB and 8.64 ± 1.89 dB on the final visit (p=0.05). At the end of follow-up period for global MD trend analysis, progression was identified in 40% of the eyes at both p<5% and p<1% levels of significance. On the other hand, cluster MD trend analysis identified progression in 85% of the eyes at both p<5% and p<1% levels of significance. Among the 10 clusters, the inferior arcuate area (Cluster 9) was the most frequently identified as progressing at both levels of significance. Overall the average rate of progression by global MD was 0.6 ± 0.87 dB/year, while the average rate of progression for cluster 9 was 0.9 ± 1.46 dB/year. At the end of follow-up period, cluster trend analysis flagged statistically significant more progressing VF defects compared to global MD trend analysis – at both p<5% (p=0.013) and p<1% levels of significance (p=0.013).
Conclusions :
Cluster MD trend analysis is more sensitive in detecting localized progression, and in monitoring glaucomatous visual field changes versus global MD trend analysis.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.