To the best of our knowledge, this is the first study of GCA algorithm reproducibility in normal, OHT and glaucomatous eyes. The reproducibility of GC-IPL thickness measurements using the Cirrus HD-OCT GCA algorithm was found to be highly satisfactory. GC-IPL thickness may be a promising new OCT parameter for analysis of ganglion cell damage in glaucoma.

PurposeTo compare a new visual field analyser, Compass, that included an eye tracking and scanning ophthalmoloscopy to Humphrey visual field analyser (HFA).MethodsProspective cross study design.Patients were included after a complete examination: all were indemn of ocular disease except glaucoma. Visual acuity was 20/20 for each eye and spherical equivalent ranged from +3 to −3 D.Patients were randomly assigned to one instrument. HFA was performed with a 24‐2 SITA standard strategy comparable to the Compass 24‐2 ZEST strategy. Both eyes were tested and 30 min after where screened with the other instrument.MD, PSD and exam duration were compared for both devices using a Wilcoxon signed‐rank test. Agreement was evaluated with a Bland‐Altman graph for each parameter.ResultsThe study included 67 eyes of 30 patients. This population was decomposed as: 13 normal eyes, 28 OHT or glaucoma suspect and 26 glaucoma. Patients’ demographics were (mean ± SD): age 66.3 ± 13.0 years, pachymetry 527.6 ± 28.95 μm, axial length 23.73 ± 0.99 mm, spherical equivalent −0.004 ± 1.3 D. 65 HFA vs. 62 compass visual fields were reliable (ns). Mean Deviation was equivalent for HFA and Compass instruments: −1.6 ± 2.6 vs. −1.4 ± 2.8 dB (p = 0.28). Pattern Standard Deviation was significantly higher for the Compass 3.9 ± 2.4 vs. 2.4 ± 1.9 dB for the HFA (p < 0.0001). Examen duration was also longer for the Compass 351 ± 83 s vs. 318 ± 48 s for the HFA (p = 0.0164). Bland Altman plots showed a good agreement between HFA and Compass.ConclusionsThis study shows that MD and failure rate were comparable between both instruments, PSD and examination duration were slightly higher for the Compass. Agreement was good between both instruments.As most of the patients included had already performed a HFA before, this may explain the duration difference between and should be consider in further explorations.

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Delivery of a dexamethasone intravitreal implant (Ozurdex, Allergan) was planned for a man in his 60s with postsurgical cystoid macular edema. Best-corrected visual acuity was 20/60 OD and central subfield thickness was 553 μm. The injection was accidentally performed in the subconjonctival space (Figure , A). The device broke into 3 parts but it was not removed. Intraocular pressure did not exceed 17 mm Hg without treatment during a close follow-up, but 3 weeks later, the patient developed an endothelial decompensation. Best-corrected visual acuity dropped to 20/200 OD and the implant was surgically removed immediately. Bestcorrected visual acuity was 20/60 OD with a clear cornea by 15 days after removal of the implant and a combination of dimethicone drops and hyperosmotic sodium chloride drops. Another dexamethasone intravitreal implant was given 45 days after removal of the implant (visual acuity, 20/60 OD; central subfield thickness, 485 μm) and macular edema was noted to have resolved by 7 days after implantation (visual acuity, 20/30 OD; central subfield thickness, 305 μm).

Glaucoma is a progressive optic neuropathy with characteristic changes to the optic nerve head and the visual field (VF). Detecting progression of VF damage with Standard Automated Perimetry (SAP) is of paramount importance for clinical care. One common approach to detecting progression is to compare each new VF test to a baseline SAP test (event analysis). This comparison is made difficult by the test–retest variability of SAP, which increases with the level of VF damage, and the limited range of measurement, meaning that damage cannot be assessed below a certain level. We performed a prospective international multi-centre data collection of SAP data on 90 eyes from 90 people with glaucoma and different levels of VF damage over a short period of time (6 tests in 60 days). Data were collected using a fundus tracked perimeter (Compass, CenterVue). We used these data (minus the first test) to develop an improved event analysis that accounts for both the change in variability with damage and the lower bound on the measurement imposed by SAP. Using simulations, we show that our approach is more sensitive compared to previously developed methods, especially in the case of advanced glaucoma, while retaining similar specificity.