| Title |
Event-based analysis of visual field change can miss fast glaucoma progression detected by a combined structure and function index
|
|---|---|
| Published in |
Graefe's Archive for Clinical and Experimental Ophthalmology, April 2018
|
| DOI | 10.1007/s00417-018-3963-3 |
| Pubmed ID | |
| Authors |
Chunwei Zhang, Andrew J. Tatham, Fábio B. Daga, Alessandro A. Jammal, Felipe A. Medeiros |
| Abstract |
To investigate the relationship between progression assessed by the visual field guided progression analysis (GPA) and rates of structural and functional change in glaucoma eyes. This was a longitudinal observational study of 135 eyes of 97 patients with glaucoma followed for an average of 3.5 ± 0.9 years. All patients had standard automated perimetry (SAP) and retinal nerve fiber layer (RNFL) analysis with spectral domain optical coherence tomography (SDOCT), with an average of 6.8 ± 2.3 visits. A control group of healthy eyes followed longitudinally was used to estimate age-related change. Visual field progression was assessed using the Humphrey Field Analyzer GPA. Estimates of retinal ganglion cell counts from SAP and SDOCT were used to obtain a combined index of glaucomatous damage (RGC index) according to a previously described algorithm. Progression by SDOCT and the retinal ganglion cell (RGC) index were defined as statistically significant (P < 0.05) slopes of change that were also faster than age-related change estimated from healthy eyes. From the 135 eyes, 15 (11%) progressed by GPA, 21 (16%) progressed by SDOCT, and 31 (23%) progressed by the RGC index. Twenty-one eyes showed progression by the RGC index that was missed by the GPA. These eyes had an average rate of change in estimated RGC counts of - 28,910 cells/year, ranging from two to nine times faster than expected age-related losses. Many glaucomatous eyes that are not found to be progressing by GPA may actually have fast rates of change as detected by a combined index of structure and function. |
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 50% |
| Unknown | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 21 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 2 | 10% |
| Researcher | 2 | 10% |
| Student > Doctoral Student | 1 | 5% |
| Student > Bachelor | 1 | 5% |
| Librarian | 1 | 5% |
| Other | 4 | 19% |
| Unknown | 10 | 48% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 5 | 24% |
| Computer Science | 1 | 5% |
| Social Sciences | 1 | 5% |
| Engineering | 1 | 5% |
| Unknown | 13 | 62% |