A comparison of functional and structural measures for identifying progression of glaucoma.
OBJECTIVE
To compare glaucoma progression by functional and structural tests.


METHODS
The authors prospectively studied 33 glaucoma patients (55 eyes); 20 eyes (15 patients) had disc hemorrhage, and 35 eyes (18 patients) had exfoliation glaucoma. The following tests were performed at two baseline and three follow-up examinations: frequency doubling perimetry (FDT), 24-2 Humphrey visual fields (HVF), multifocal visual evoked potentials (mfVEP), and optical coherence tomography (OCT). To identify progression, the baseline measurements were averaged and compared to those obtained at the final examination. Stereophotographs of the optic disc were obtained at baseline and compared with those at the final examination.


RESULTS
Patients were followed up for 21.1±1.8 months. For HVF there were significant changes in mean deviation (MD) in eight (14.5%) eyes but in pattern standard deviation (P/SD) in only two (3.6%) eyes. For FDT, there were significant changes in MD in 13 (23.6%) eyes. Five eyes showed changes in MD for HVF and FDT. For mfVEP, there was an increase in abnormal points in nine (16.4%) eyes. Six of these eyes did not show significant HVF or FDT changes. For OCT, RNFL average thickness values were significantly decreased in nine (16.4%) eyes. Nine (16.4%) eyes showed progression on stereophotography; four of these eyes did not show significant changes on OCT and functional tests.


CONCLUSIONS
Each test showed evidence of progression in some eyes. However, agreement among tests and stereophotography regarding which eyes showed progression was poor, illustrating the importance of following up patients with a combination of functional and structural tests.
Xin
Daiyan
D
Department of Psychology, Columbia University, New York, NY 10027, USA.
Greenstein
Vivienne C
VC
Ritch
Robert
R
Liebmann
Jeffrey M
JM
De Moraes
Carlos Gustavo
CG
Hood
Donald C
DC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005074:Evoked Potentials, Visual / Q000502:physiology*; D017889:Exfoliation Syndrome / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000503:physiopathology; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*