Format

Send to

Choose Destination
Am J Ophthalmol. 2017 Dec;184:63-74. doi: 10.1016/j.ajo.2017.09.020. Epub 2017 Sep 28.

Comparison of Glaucoma Progression Detection by Optical Coherence Tomography and Visual Field.

Author information

1
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon.
2
Doheny Eye Center and David Geffen School of Medicine at UCLA, Los Angeles, California.
3
University of Southern California Keck School of Medicine, Los Angeles, California.
4
Bascom Palmer Eye Institute, University of Miami, Miami, Florida.
5
New York University Medical Center, New York, New York.
6
Casey Eye Institute, Oregon Health & Science University, Portland, Oregon. Electronic address: davidhuang@alum.mit.edu.

Abstract

PURPOSE:

To compare longitudinal glaucoma progression detection using optical coherence tomography (OCT) and visual field (VF).

DESIGN:

Validity assessment.

METHODS:

We analyzed subjects with more than 4 semi-annual follow-up visits (every 6 months) in the multicenter Advanced Imaging for Glaucoma Study. Fourier-domain optical coherence tomography (OCT) was used to map the thickness of the peripapillary retinal nerve fiber layer (NFL) and ganglion cell complex (GCC). OCT-based progression detection was defined as a significant negative trend for either NFL or GCC. VF progression was reached if either the event or trend analysis reached significance.

RESULTS:

The analysis included 356 glaucoma suspect/preperimetric glaucoma (GS/PPG) eyes and 153 perimetric glaucoma (PG) eyes. Follow-up length was 54.1 ± 16.2 months for GS/PPG eyes and 56.7 ± 16.0 for PG eyes. Progression was detected in 62.1% of PG eyes and 59.8% of GS/PPG eyes by OCT, significantly (P < .001) more than the detection rate of 41.8% and 27.3% by VF. In severity-stratified analysis of PG eyes, OCT had significantly higher detection rate than VF in mild PG (63.1% vs. 38.7%, P < .001), but not in moderate and advanced PG. The rate of NFL thinning slowed dramatically in advanced PG, but GCC thinning rate remained relatively steady and allowed good progression detection even in advanced disease. The Kaplan-Meier time-to-event analyses showed that OCT detected progression earlier than VF in both PG and GS/PPG groups.

CONCLUSIONS:

OCT is more sensitive than VF for the detection of progression in early glaucoma. While the utility of NFL declines in advanced glaucoma, GCC remains a sensitive progression detector from early to advanced stages.

PMID:
28964806
PMCID:
PMC5894829
DOI:
10.1016/j.ajo.2017.09.020
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center