Comparison of Rates of Change in 10-2 and 24-2 Perimetry to Detect Glaucoma Progression

Abstract

Purpose : To compare the performance of rates of change in 10-2 and 24-2 standard automated perimetry (SAP) in detecting glaucoma progression, using rates of structural loss measured by spectral-domain optical coherence tomography (OCT) as an independent reference standard for progression.

Methods : The study included 291 eyes from 185 glaucoma subjects followed for an average of 1.8±1.0 years. Sixty-nine eyes from 39 healthy subjects followed for 1.5±0.9 years were used as control group to estimate age-related losses over time. Rates of change were estimated using linear mixed models. Receiver operating characteristic (ROC) curve regression analysis was used to compare the performance of rates of change of 10-2 and 24-2 SAP mean deviation (MD) over time in discriminating eyes from the control group versus eyes that had different rates of structural progression as measured by OCT. Areas under the ROC curves (AUC) were estimated at rates of global cpRNFL thinning for pre-defined values of -1.0μm/year (slow progression) and -2.0μm/year (fast progression).

Results : Mean rates of change were -0.14±0.18 dB/year and -0.27±0.23 dB/year for 10-2 SAP MD and 24-2 SAP MD, respectively. Rates of change in 24-2 SAP MD performed significantly better than 10-2 SAP MD to discriminate age-related loss from glaucomatous change, as measured by OCT (AUC = 0.808 versus 0.721, respectively; P = 0.011). For discriminating slow progressors from controls, 10-2 SAP had an AUC of 0.715 (95% CI: 0.622-0.808) versus 0.827 (95% CI: 0.763-0.893) for 24-2. For detecting fast progression, the AUCs were 0.707 (95% CI: 0.578-0.836) versus 0.853 (0.767-0.938), respectively.

Conclusions : SAP testing with the 24-2 pattern of points performed better than the 10-2 for detecting eyes with glaucomatous progression as determined by OCT.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.