title: Detecting the progression of normal tension glaucoma: a comparison of perimetry, optic coherence tomography, and Heidelberg retinal tomography.
abstract: OBJECTIVE
  We compared the abilities of Stratus optical coherence tomography (OCT), Heidelberg retinal tomography (HRT) and standard automated perimetry (SAP) to detect the progression of normal tension glaucoma (NTG) in patients whose eyes displayed localized retinal nerve fiber layer (RNFL) defect enlargements.
  
  
  METHODS
  One hundred four NTG patients were selected who met the selection criteria: a localized RNFL defect visible on red-free fundus photography, a minimum of five years of follow-up, and a minimum of five reliable SAP, Stratus OCT and HRT tests. Tests which detected progression at any visit during the 5-year follow-up were identified, and patients were further classified according to the state of the glaucoma using the mean deviation (MD) of SAP. For each test, the overall rates of change were calculated for parameters that differed significantly between patients with and without NTG progression.
  
  
  RESULTS
  Forty-seven (45%) out of 104 eyes displayed progression that could be detected by red-free fundus photography. Progression was detected in 27 (57%) eyes using SAP, 19 (40%) eyes using OCT, and 17 (36%) eyes using HRT. In early NTG, SAP detected progression in 44% of eyes, and this increased to 70% in advanced NTG. In contrast, OCT and HRT detected progression in 50 and 7% of eyes during early NTG, but only 30 and 0% of eyes in advanced NTG, respectively. Among several parameters, the rates of change that differed significantly between patients with and without progression were the MD of SAP (p = 0.013), and the inferior RNFL thickness (p = 0.041) and average RNFL thickness (p = 0.032) determined by OCT.
  
  
  CONCLUSIONS
  SAP had a higher detection rate of NTG progression than other tests, especially in patients with advanced glaucoma, when we defined progression as the enlargement of a localized RNFL defect. The rates of change of the MD of SAP, inferior RNFL thickness, and average RNFL thickness differed between NTG patients with and without progression.
authors: Department of Ophthalmology, Saevit Eye Hospital, Goyang, Korea. ; Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Jae-Yoon
authors: JY
authors: Yoon
authors: Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Jong Kyung
authors: JK
authors: Na
authors: Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
authors: Chan Kee
authors: CK
authors: Park
mesh_terms: D018450:Disease Progression; D005260:Female; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D057066:Low Tension Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D041623:Tomography, Optical Coherence / Q000379:methods*; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields / Q000502:physiology*
keywords: Glaucoma progression; Heidelberg retinal tomography; Low tension glaucoma; Optical coherence tomography; Standard automated perimetry
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