Abstract
Purpose :
Early detection of glaucoma progression is essential in glaucoma management. We tested the hypothesis that a global index derived from the central 12 points of the 24-2 visual field (CMD12) could detect functional progression as well as the 10-2 visual field (VF) mean deviation (10-2 MD).
Methods :
125 eyes (125 glaucoma patients) with central or moderate to severe damage from the Advanced Glaucoma Progression Study with four or more pairs of 10-2 SITA standard and 24-2 SITA standard VFs were enrolled. Baseline 10-2 and 24-2 VF dates were within six months and the remaining pairs were from the same session. The CMD12 was calculated by averaging total deviation (TD) values in the central 12 points of 24-2 visual fields. Simple linear regression was used to estimate 10-2 MD, 24-2 MD, and CMD12 slopes. Progression at final follow-up visit was defined as a confirmed slope <0 dB/year with a p<0.05 for any global index.
Results :
The 3 global indices were highly correlated at baseline: r=0.62 (95% CI=0.52-0.74) between 10-2 MD and 24-2 MD, 0.84 (0.78-0.90) between CMD12 and 24-2 MD, and 0.86 (0.80-0.92) between 10-2 MD and CMD12 (Figure1). The corresponding correlations between slopes of global indices were weaker: r=0.37 (0.11-0.65), 0.80 (0.70-0.92), and 0.46, respectively.
Glaucoma progression was detected in 22 cases based on the 10-2 slopes and in 23 cases according to CMD12 slopes, with 12 cases exhibiting progression on both (Figure 2).
Conclusions :
While central MD does not obviate the need for 10-2 VF MD, it can add to the information available from serial visual fields. Incorporating the central 12-point MD from 24-2 VFs alongside or instead of 10-2 MD will enhance detection of progression as opposed to 24-2 visual fields alone.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.