Comparison of Event-Based Methods Using Optical Coherence Tomography and Automated Perimetry to Detect the Progression of Glaucoma in Patients with Open-Angle Glaucoma

Abstract

Background/Aims: To compare event-based methods for estimating the incidence of glaucoma progression using optical coherence tomography (OCT) and automated perimetry and to assess agreement between structural and functional tests for detecting glaucoma progression. Methods: Functional progression of glaucoma was estimated by guided progression analysis (GPA) using a Humphrey field analyzer (HFA), and structural progression was assessed by OCT and defined as the decrease in retinal nerve fiber layer thickness based on test-retest variability data of previous reports on clock-hour and quadrant maps. The level of agreement between structural and functional progression was evaluated using kappa statistics. Results: Fifty eyes of 50 patients with open-angle glaucoma were enrolled in this retrospective study. The incidence of visual field progression estimated by GPA was 18%. The occurrence of structural progression assessed by OCT ranged from 18 to 68%. The more stringent OCT progression criterion using a quadrant map showed the best agreement with HFA GPA (ĸ = 0.423) and detected perimetric progression with high specificity, while the less stringent OCT criterion considering any clock hour showed the lowest agreement with functional progression (ĸ = 0.098). Conclusion: OCT progression criteria based on test-retest variability showed moderate agreement with perimetric progression, and more stringent criteria showed better agreement with functional progression than less stringent ones.

Comparison of event-based analysis of glaucoma progression assessed subjectively on visual fields and retinal nerve fibre layer attenuation measured by optical coherence tomography

“…Their study showed poor concordance between structural and functional criteria; 22 % of their patients progressed by OCT alone, 9 % by VF-MD alone and 3 % by both VF and OCT. Recently, Lee et al [29] compared event-based analysis on Stratus OCT with progression on visual fields and reported moderate agreement between structural and functional methods of assessment, but they did not mention details of the percentage change or decrease in RNFL thickness observed in their study.…”