title: Comparison of event-based analysis of glaucoma progression assessed subjectively on visual fields and retinal nerve fibre layer attenuation measured by optical coherence tomography.
abstract: The purpose is to study the ability of an event-based analysis of retinal nerve fibre layer (RNFL) attenuation measured by Stratus(®) optical coherence tomography (OCT) and to detect progression across the spectrum of glaucoma. Adult glaucoma suspects, ocular hypertensives and glaucoma patients who had undergone baseline RNFL thickness measurement on Stratus OCT and reliable automated visual field examination by Humphrey's visual field analyser prior to March 2007 and had 5-year follow-up data were recruited. Progression on OCT was defined by two criteria: decrease in average RNFL thickness from baseline by at least 10 and 20 µ. Visual field progression was defined by the modified Hodapp-Parrish-Anderson criteria. Absolute and percentage change in RNFL thickness from baseline was compared in progressors and non-progressors on visual fields. Concordance between structural and functional progression was analysed. 318 eyes of 162 patients were analysed. 35 eyes (11 %) progressed by visual fields, 8 (2.5 %) progressed using the 20 µ loss criterion, while 30 eyes (9.4 %) progressed using the 10 µ loss criterion. In glaucoma suspects, mean absolute RNFL attenuation was 8.6 µ (12.1 % of baseline) in those who progressed to glaucoma by visual fields. OCT was more useful to detect progression in early glaucoma, but performed poorly in advanced glaucoma. The 10 µ criterion appears to be closer to visual field progression. However, the ability to detect progression varies considerably between functional and structural tools depending upon the severity of the disease.
authors.affiliation: Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. sushmita_kaushik@yahoo.com.
authors.forename: Sushmita
authors.initials: S
authors.lastname: Kaushik
authors.affiliation: Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Samyak
authors.initials: S
authors.lastname: Mulkutkar
authors.affiliation: Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Surinder Singh
authors.initials: SS
authors.lastname: Pandav
authors.affiliation: Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Verma
authors.affiliation: Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
mesh_terms: D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers; D009798:Ocular Hypertension / Q000175:diagnosis / Q000503:physiopathology; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D011446:Prospective Studies; D012165:Retinal Ganglion Cells / Q000473:pathology*; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence / Q000379:methods*; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*
keywords: Event based; Glaucoma progression; OCT