PURPOSE.To compare frequency- doubling technology (FDT) perimetry with standard automated perimetry (SAP) for detecting glaucomatous visual field progression in a longitudinal prospective study. METHODS. One eye of pa...PURPOSE.To compare frequency- doubling technology (FDT) perimetry with standard automated perimetry (SAP) for detecting glaucomatous visual field progression in a longitudinal prospective study. METHODS. One eye of patients with open- angle glaucomawas tested every 6 monthswith both FDT and SAP. A minimum of 6 examinations with each perimetric technique was required for inclusion. Visual field progression was determined by two methods: glaucoma change probability (GCP) analysis and linear regression analysis (LRA). For GCP, several criteria for progression were used. The number of locations required to classify progression with FDT compared with SAP, respectively, was 1:2 (least conservative), 1:3, 2:3, 2:4, 2:6, 2:7, 3:6, 3:7, and 3:10 (most conservative). The number of consecutive examinations required to confirm progression was 2- of- 3, 2- of- 2, and 3- of- 3. For LRA, the progression criterion was any significant decline in mean threshold sensitivity over time in each of the following three visual field subdivisions: (1) all test locations, (2) locations in the central 10° and the superior and inferior hemifields, and (3) locations in each quadrant. Using these criteria, the proportion of patients classified as showing progression with each perimetric technique was calculated and, in the case of progression with both, the differences in time to progression were determined. RESULTS. Sixty- five patients were followed for a median of 3.5 years (median number of examinations, 9). For the least conservative GCP criterion, 32 (49% ) patients were found to have progressing visual fields with FDT and 32 (49% ) patients with SAP. Only 16 (25% ) patients showed progression with both methods, and in most of those patients, FDT identified progression before SAP (median, 12 months earlier). The majority of GCP progression criteria (15/27), classified more patients as showing progression with FDT than with SAP. Contrary to this, more patients showed progression with SAP than FDT, when analysed with LRA; e.g., using quadrant LRA 20 (31% ) patients showed progressionwith FDT, 23 (35% ) with SAP, and only 10 (15% ) with both. CONCLUSIONS. FDT perimetry detected glaucomatous visual field progression. However, the proportion of patients who showed progression with both FDT and SAP was small, possibly indicating that the two techniques identify different subgroups of patients. Using GCP, more patients showed progression with FDT than with SAP, yet the opposite occurred using LRA. As there is no independent qualifier of progression, FDT and SAP progression rates vary depending on the method of analysis and the criterion used.展开更多
Aims: To determine whether central corneal thickness (CCT) is a significant pr edictor of visual field and optic disc progression in open angle glaucoma. Metho ds: Data were obtained from a prospective study of glauco...Aims: To determine whether central corneal thickness (CCT) is a significant pr edictor of visual field and optic disc progression in open angle glaucoma. Metho ds: Data were obtained from a prospective study of glaucoma patients tested with static automated perimetry and confocal scanning laser tomography every 6 month s. Progression was determined using a trend based approach called evidence of ch ange (EOC) analysis in which sectoral ordinal scores based on the significance o f regression coefficients of visual field pattern deviation and neuroretinal rim area over time are summed. Visual field progression was also determined using t he event based glaucoma change probability (GCP) analysis using both total and p attern deviation. Results: The sample contained 101 eyes of 54 patients (mean (S D) age 56.5 (9.8) years) with a mean follow up of 9.2 (0.7) years and 20.7 (2.3) sets of examinations every 6 months. Lower CCT was associated with worse baseli ne visual fields and lower mean IOP in the follow up. In the longitudinal analys is CCT was not correlated with the EOC scores for visual field or optic disc cha nge. In the GCP analyses, there was a tendency for groups classified as progress ing to have lower CCT compared to nonprogressing groups. In a multivariate analy ses accounting for IOP, the opposite was found, whereby higher CCT was associate d with visual field progression. None of the independent factors were predictive of optic disc progression. Conclusions: In this cohort of patients with establi shed glaucoma, CCT was not a useful index in the risk assessment of visual field and optic disc progression.展开更多
文摘PURPOSE.To compare frequency- doubling technology (FDT) perimetry with standard automated perimetry (SAP) for detecting glaucomatous visual field progression in a longitudinal prospective study. METHODS. One eye of patients with open- angle glaucomawas tested every 6 monthswith both FDT and SAP. A minimum of 6 examinations with each perimetric technique was required for inclusion. Visual field progression was determined by two methods: glaucoma change probability (GCP) analysis and linear regression analysis (LRA). For GCP, several criteria for progression were used. The number of locations required to classify progression with FDT compared with SAP, respectively, was 1:2 (least conservative), 1:3, 2:3, 2:4, 2:6, 2:7, 3:6, 3:7, and 3:10 (most conservative). The number of consecutive examinations required to confirm progression was 2- of- 3, 2- of- 2, and 3- of- 3. For LRA, the progression criterion was any significant decline in mean threshold sensitivity over time in each of the following three visual field subdivisions: (1) all test locations, (2) locations in the central 10° and the superior and inferior hemifields, and (3) locations in each quadrant. Using these criteria, the proportion of patients classified as showing progression with each perimetric technique was calculated and, in the case of progression with both, the differences in time to progression were determined. RESULTS. Sixty- five patients were followed for a median of 3.5 years (median number of examinations, 9). For the least conservative GCP criterion, 32 (49% ) patients were found to have progressing visual fields with FDT and 32 (49% ) patients with SAP. Only 16 (25% ) patients showed progression with both methods, and in most of those patients, FDT identified progression before SAP (median, 12 months earlier). The majority of GCP progression criteria (15/27), classified more patients as showing progression with FDT than with SAP. Contrary to this, more patients showed progression with SAP than FDT, when analysed with LRA; e.g., using quadrant LRA 20 (31% ) patients showed progressionwith FDT, 23 (35% ) with SAP, and only 10 (15% ) with both. CONCLUSIONS. FDT perimetry detected glaucomatous visual field progression. However, the proportion of patients who showed progression with both FDT and SAP was small, possibly indicating that the two techniques identify different subgroups of patients. Using GCP, more patients showed progression with FDT than with SAP, yet the opposite occurred using LRA. As there is no independent qualifier of progression, FDT and SAP progression rates vary depending on the method of analysis and the criterion used.
文摘Aims: To determine whether central corneal thickness (CCT) is a significant pr edictor of visual field and optic disc progression in open angle glaucoma. Metho ds: Data were obtained from a prospective study of glaucoma patients tested with static automated perimetry and confocal scanning laser tomography every 6 month s. Progression was determined using a trend based approach called evidence of ch ange (EOC) analysis in which sectoral ordinal scores based on the significance o f regression coefficients of visual field pattern deviation and neuroretinal rim area over time are summed. Visual field progression was also determined using t he event based glaucoma change probability (GCP) analysis using both total and p attern deviation. Results: The sample contained 101 eyes of 54 patients (mean (S D) age 56.5 (9.8) years) with a mean follow up of 9.2 (0.7) years and 20.7 (2.3) sets of examinations every 6 months. Lower CCT was associated with worse baseli ne visual fields and lower mean IOP in the follow up. In the longitudinal analys is CCT was not correlated with the EOC scores for visual field or optic disc cha nge. In the GCP analyses, there was a tendency for groups classified as progress ing to have lower CCT compared to nonprogressing groups. In a multivariate analy ses accounting for IOP, the opposite was found, whereby higher CCT was associate d with visual field progression. None of the independent factors were predictive of optic disc progression. Conclusions: In this cohort of patients with establi shed glaucoma, CCT was not a useful index in the risk assessment of visual field and optic disc progression.
