title: Detecting Change Using Standard Global Perimetric Indices in Glaucoma.
abstract: OBJECTIVE
  Various global indices are available to summarize results from standard automated perimetry. This study asks which index can detect significant deterioration earliest, for a fixed specificity.
  
  
  METHODS
  Comparison of prognostic indices.
  
  
  METHODS
  Two cohorts were tested. A test-retest cohort contained 5 reliable visual fields, within a short interval, from 45 eyes of 23 participants with glaucoma and/or likelihood of developing glaucoma. A separate longitudinal cohort contained 508 eyes from 330 participants, tested on average 13 times. Three global indices were extracted: mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI). For each index we defined a critical P value CritIndex, such that 5% of test-retest series showed significant deterioration with P < CritIndex, using artificial "test dates" in random order. Therefore these criteria have 95% specificity over series of 5 tests. The times to detect significant deterioration in the longitudinal cohort were compared using a survival analysis model.
  
  
  RESULTS
  The median time to detect significant deterioration with MD was 7.3 years (95% confidence interval [CI] 6.8-7.9 years). For VFI, the median was 8.5 years (95% CI 7.9-9.0 years); this comparison had P = .088. For PSD, the median was 10.5 years (95% CI 9.3-11.7 years), slower than MD with P < .001. Within the first 5 years of a series, MD detected significant deterioration in 138 eyes, vs 104 for VFI (P = .0013) and 107 for PSD (P = .029).
  
  
  CONCLUSIONS
  MD detected significant deterioration sooner than VFI or PSD. In particular, MD detected more eyes in the first 5 years of their follow-up, which were presumably undergoing more rapid progression.
authors.affiliation: Devers Eye Institute, Legacy Research Institute, Portland, Oregon. Electronic address: sgardiner@deverseye.org.
authors.forename: Stuart K
authors.initials: SK
authors.lastname: Gardiner
authors.affiliation: Devers Eye Institute, Legacy Research Institute, Portland, Oregon.
authors.forename: Shaban
authors.initials: S
authors.lastname: Demirel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D058609:Visual Field Tests / Q000379:methods*; D014794:Visual Fields / Q000502:physiology*