title: Structural and Functional Progression in the Early Manifest Glaucoma Trial.
abstract: To elucidate the temporal relationship between detection of glaucomatous optic disc progression, as assessed by fundus photography, and visual field progression.
  
  
  
  Prospective, randomized, longitudinal trial.
  
  
  
  Three hundred six study eyes with manifest glaucoma with field loss and 192 fellow eyes without any field defect at the start of the trial, from a total of 249 subjects included in the Early Manifest Glaucoma Trial (EMGT), were assessed.
  
  
  
  Evaluation of visual field progression and optic disc progression during an 8-year follow-up period. Three graders independently assessed optic disc progression in optic disc photographs. Visual field progression was assessed using glaucoma change probability maps and the EMGT progression criterion.
  
  
  
  Time to detection of visual field progression and optic disc progression.
  
  
  
  Among study eyes with manifest glaucoma, progression was detected in the visual field first in 163 eyes (52%) and in the optic disc first in 39 eyes (12%); in 1 eye (0%), it was found simultaneously with both methods. Among fellow eyes with normal fields, progression was detected in the visual field first in 28 eyes (15%) and in the optic disc first in 34 eyes (18%); in 1 eye (1%), it occurred simultaneously.
  
  
  
  In eyes with manifest glaucoma, progression in the visual field was detected first more than 4 times as often as progression in the optic disc. Among fellow eyes without visual field loss at baseline, progression was detected first as frequently in the optic disc as in the visual field.
authors.affiliation: Department of Clinical Sciences in Malmö, Ophthalmology, Lund University, Sweden. Electronic address: hannamaria.ohnell@med.lu.se.
authors.forename: HannaMaria
authors.initials: H
authors.lastname: Öhnell
authors.affiliation: Department of Clinical Sciences in Malmö, Ophthalmology, Lund University, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Heijl
authors.affiliation: Helsingborg Hospital, Helsingborg, Sweden.
authors.forename: Lena
authors.initials: L
authors.lastname: Brenner
authors.affiliation: Department of Clinical Sciences Lund, Cancer Epidemiology, Lund University, Sweden.
authors.forename: Harald
authors.initials: H
authors.lastname: Anderson
authors.affiliation: Department of Clinical Sciences in Malmö, Ophthalmology, Lund University, Sweden.
authors.forename: Boel
authors.initials: B
authors.lastname: Bengtsson
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use; D000368:Aged; D015784:Betaxolol / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000175:diagnosis*; D010781:Photography; D011446:Prospective Studies; D013997:Time Factors; D014130:Trabeculectomy; D014786:Vision Disorders / Q000175:diagnosis*; D058609:Visual Field Tests; D014794:Visual Fields
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D015784:Betaxolol