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 2018-07, Vol.256 (7), p.1227-1234
• Main Authors: Zhang, Chunwei, Tatham, Andrew J., Daga, Fábio B., Jammal, Alessandro A., Medeiros, Felipe A.
• Format: Article
• Language: English
• Subjects: Age; Eye; Glaucoma; Medicine; Medicine & Public Health; Ophthalmology; Retina; Retinal ganglion cells; Statistical analysis; Structure-function relationships; Visual field
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-018-3963-3

Purpose 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. Methods 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