Perimetric indices as predictors of future glaucomatous functional change.
OBJECTIVE
To evaluate the use of global indices summarizing the current status of a patient's visual field as predictors of their future rate of change.


METHODS
Ninety-five subjects with early or suspected glaucoma were studied, of whom 50 exhibited glaucomatous optic neuropathy (GON) at baseline. Subjects underwent seven annual visual field tests. Results from the first test in the sequence were used to predict their subsequent rate of change. Two global indices were considered: mean deviation (MD) and pattern standard deviation (PSD).


RESULTS
Using multiple linear regression, baseline MD predicted subsequent slope of MD significantly better than baseline PSD predicted subsequent slope of PSD (p = 0.017). Using multiple logistic regression, a worse initial MD was predictive of being in the worst tertile for subsequent change in MD (pseudo-R2 = 0.33 for subjects with GON at baseline and 0.31 for those without). Worse initial PSD was not predictive of being in the worst tertile for subsequent change in PSD (pseudo-R2 = 0.09 with GON at baseline, 0.10 without).


CONCLUSIONS
Among patients with otherwise similar clinical profiles, a worse visual field at baseline, as measured by the global index MD, is predictive of a more rapid future rate of change. This should be taken into account when clinical decisions are made concerning management of patients who already have some visual field damage at presentation.
Gardiner
Stuart K
SK
Discoveries in Sight Laboratories, Devers Eye Institute, Legacy Health, Portland, Oregon 97232, USA. sgardiner@deverseye.org
Demirel
Shaban
S
Johnson
Chris A
CA
D000368:Aged; D015331:Cohort Studies; D018450:Disease Progression; D005901:Glaucoma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000150:complications; D011237:Predictive Value of Tests; D013997:Time Factors; D014787:Vision Tests; D058609:Visual Field Tests; D014794:Visual Fields