A Comparison of Visual Field Progression Criteria of 3 Major Glaucoma Trials in Early Manifest Glaucoma Trial Patients

Heijl, Anders; Bengtsson, Bo; Chauhan, Balwantray C.; Lieberman, Marc F.; Cunliffe, I A; Hyman, Leslie; Leske, M. Cristina

doi:10.1016/j.ophtha.2008.02.005

Cited by 120 publications

(98 citation statements)

References 23 publications

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“…Differences in the definition of visual field progression may also explain the disparities between our results. Previous studies 20,[35][36][37][38] have shown that different progression criteria do not necessarily identify the same eyes as progressing. The study by Medeiros and colleagues defined SAP progression using an event analysis derived from the Early Manifest Glaucoma Trial 39 consisting of a change in three or more of the same test points on three follow-up consecutive tests.…”

Section: Discussionmentioning

confidence: 99%

Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Niles

Greenfield

Sehi

et al. 2012

Eye

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Aims To examine the rate of macular thickness loss using time-domain optical coherence tomography (OCT) in functionally progressing versus non-progressing eyes, determined by standard automated perimetry (SAP). Methods Glaucoma suspects (GS) and glaucomatous (G) eyes underwent SAP and OCT imaging every 6 months. Functional progression was determined using pointwise linear regression, defined as 2 contiguous locations losing Z1.0 dB/year at Po1.0% in the same hemifield. The annual rate of macular thickness loss was calculated from inner and outer regions of the macular map. Results 72 eyes (43 GS and 29G) with Z30 months of follow-up were enroled. Fourteen eyes demonstrated SAP progression. The annual rate of macular thickness loss (mm/year) in progressing eyes was faster (all Po0.05) than non-progressing eyes in temporal outer ( À 1.90±2.97 vs 0.33±2.77), nasal inner ( À 1.70±2.66 vs 0.14±2.76), superior inner ( À 2.15 ± 4.57 vs 0.51 ± 2.99), temporal inner quadrants ( À 2.58 ± 5.05 vs À 0.38 ± 2.34), and the average of inner macular quadrants ( À 1.84 ± 2.90 vs 0.03 ± 2.10). The rate of loss in the nasal inner (P ¼ 0.02) and temporal outer (P ¼ 0.02) macular regions was associated with optic disc haemorrhage. Conclusions Eyes with SAP progression have significantly greater rates of macular thickness loss consistent with glaucomatous retinal ganglion cell atrophy, as compared with non-progressing eyes.

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Section: Discussionmentioning

confidence: 99%

Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Niles

Greenfield

Sehi

et al. 2012

Eye

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“…Although there is no gold standard for visual field worsening, the EMGT criteria are considered one of the more sensitive techniques among available methods for detection of glaucoma worsening. 9,19 Therefore, the higher proportion of test locations worsening according to PLR in the stable group when less stringent criteria are used likely represents false detection. Using global indices for estimating rates of change with no cutoff criteria for the magnitude of worsening seems reasonable and more intuitive clinically.…”

Section: Discussionmentioning

confidence: 99%

“…While it has been demonstrated that threshold sensitivities uncorrected for generalized depression of the hill of vision (or total deviation data) are superior to corrected sensitivities for detection of worsening with trend analyses, 7,8 the current GPA software uses corrected sensitivities or pattern deviation data and has been shown to be reasonably sensitive and specific. 6,9 Although pointwise event analysis provides clinicians with valuable information regarding possible clinically significant deterioration of the visual field, it does not provide any temporal information (i.e., rates of decay). Significant worsening of the visual field needs to be interpreted within the context of the disease, especially rates of change and the remaining lifetime of the patient.…”

Section: Methodsmentioning

confidence: 99%

Global and Pointwise Rates of Decay in Glaucoma Eyes Deteriorating according to Pointwise Event Analysis

Nassiri

Moghimi

Coleman

et al. 2013

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To estimate rates of change in glaucoma eyes deteriorating according to pointwise event analysis (Guided Progression Analysis, GPA). METHODS.A total of 274 eyes with six or more reliable visual fields (VF) ‡ 5 years were enrolled (baseline mean deviation [MD]: À4.2 6 4.5 dB). Pointwise and global rates of decay from linear regression analyses were estimated up to the time of VF deterioration according to GPA or until the last follow-up visit in stable eyes. Relationship of rates of decay with time to worsening and eccentricity and agreement of global and pointwise trend analyses with GPA were explored.RESULTS. Seventy eyes (25.5%) worsened according to GPA. A statistically significant global rate of decay (P < 0.05) was observed in 54% (MD) and 62% (visual field index) of deteriorating eyes compared to 22% and 22% in stable eyes (j ¼ 0.32 vs. 0.37 for agreement with GPA). Rates of decay diminished with longer time to initial worsening and were faster in points within the central 108 of fixation compared to 208 and 308 regions (P ¼ 0.025 and 0.279, respectively). Established criteria for pointwise linear regression (PLR) detected only 31% of locations deteriorating by GPA. Less stringent PLR criteria led to improved agreement with GPA at the expense of higher false detection rate.CONCLUSIONS. Global and pointwise rates of decay decreased with longer time to VF deterioration. The agreement between pointwise event analysis and global trend analyses was fair. Less stringent criteria for PLR led to improved agreement with GPA at the expense of higher false detection rate. (Invest Ophthalmol Vis Sci. 2013;54:1208-1213 DOI:10.1167/ iovs.12-10833 A ccurate methods to measure rates of decay in glaucoma are essential to monitor patients and evaluate the efficacy of therapy. Standard achromatic perimetry (SAP) remains the gold standard for measuring the extent of functional damage in glaucoma and for detecting disease worsening over time.

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“…Progression was defined as worsening of visual fields according to pre-defined criteria 6 based on computerized analyses using glaucoma change probability maps, 7 which have been shown to offer high sensitivity and specificity. 8,9 Glaucoma progression could also be identified as worsening of the disc, which was assessed by masked readings at a disc photography reading center. 6,10 The protocol included a "safety hatch" that entailed an exception to the principle of unchanged therapy; in short, if the IOP in treated eyes exceeded 25 mmHg at two consecutive follow-up visits, additional pressure-lowering eye drops were prescribed.…”

Section: Methodsmentioning

confidence: 99%

Effects of Argon Laser Trabeculoplasty in the Early Manifest Glaucoma Trial

Heijl

Peters

Leske

et al. 2011

American Journal of Ophthalmology

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Methods: Patients randomized to the treatment arm of the EMGT received a standard treatment protocol (topical betaxolol hydrochloride followed by 360°ALT) and were then followed prospectively at 3-month intervals for up to 8 years. One eye per patient was included in the analyses. We investigated the relationship between pre-ALT IOP and subsequent IOP reduction, and other factors that might have influenced the effect of ALT, including stage of the disease, trabecular pigmentation, presence of exfoliation syndrome, and treating surgeon.Results: The mean pre-ALT IOP after betaxolol was 18.1 mmHg ± 3.9 (SD), and the mean short-term IOP reduction 3 months after ALT was 2.8 mmHg ± 3.9 (SD) (12.6%

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A Comparison of Visual Field Progression Criteria of 3 Major Glaucoma Trials in Early Manifest Glaucoma Trial Patients

Cited by 120 publications

References 23 publications

Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Global and Pointwise Rates of Decay in Glaucoma Eyes Deteriorating according to Pointwise Event Analysis

Effects of Argon Laser Trabeculoplasty in the Early Manifest Glaucoma Trial

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