Enhanced Glaucoma Staging System (GSS 2) for Classifying Functional Damage in Glaucoma

Brusini, Paolo; Filacorda, Stefano

doi:10.1097/01.ijg.0000195932.48288.97

Cited by 195 publications

(154 citation statements)

References 20 publications

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“…In fact, in our study, we correlated the reduction of the N1-P1 mfERG amplitudes and the increase of P1 IT detected in the two more central rings (R1-R2) with the generally used perimetric indices of glaucomatous damage (HFA MD and CPSD), 63 exclusively to assess whether the dysfunction observed in the macular area could be related to the grade of severity of OAG disease. We found a significant correlation between HFA MD and CPSD parameters and the N1-P1 mfERG RADs.…”

Section: Discussionmentioning

confidence: 99%

Macular Function in Eyes with Open-Angle Glaucoma Evaluated by Multifocal Electroretinogram

Parisi

Ziccardi

Centofanti³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To evaluate macular function in patients with openangle glaucoma (OAG) by means of multifocal electroretinogram (mfERG).METHODS. Twenty-four OAG patients (mean age 54.6 6 9.1 years) and 14 age-similar controls were enrolled. OAG patients had intraocular pressure (IOP) less than 18 mm Hg with topical medical treatment, 24-2 visual field (Humphrey Field Analyzer [HFA]) with mean deviation (MD) between À2 and À12 dB, and corrected pattern standard deviation (CPSD) between þ2 and þ10 dB and no history or presence of cataract and/or macular disease. MfERGs in response to 61 M-stimuli presented to the central 208 of the visual field were assessed in OAG patients (24 eyes) and in controls (14 eyes). Ring (R) analysis was performed every five retinal eccentricities in areas between the fovea and midperiphery: 08 to 2.58 (R1), 2.58 to 58 (R2), 58 to 108 (R3), 108 to 158 (R4), and 158 to 208 (R5). MfERG response amplitude density of the N1-P1 components (N1-P1 RAD, nV/deg 2 ) and P1 implicit time (P1 IT, ms) of the firstorder binary kernel were measured for each ring.RESULTS. OAG patients showed a significant (P < 0.01) decrease in N1-P1 RADs and an increase in P1 IT in both R1 and R2 with respect to controls. The reduction in N1-P1 RADs was significantly (P < 0.01) correlated with HFA MD and CPSD. No other significant differences between OAG and controls were found.CONCLUSIONS. OAG patients show macular dysfunction detectable by the mfERG technique. Since the mfERG N1-P1 component is thought to be generated by preganglionic elements (photoreceptors and OFF bipolar cells), our data support the functional impairment of the neural generators of the macular region in patients with glaucoma. (Invest Ophthalmol Vis Sci. 2012;53:6973-6980)

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Section: Discussionmentioning

confidence: 99%

Macular Function in Eyes with Open-Angle Glaucoma Evaluated by Multifocal Electroretinogram

Parisi

Ziccardi

Centofanti³

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…Abnormal SAP results were considered to be a reproducible glaucomatous VF loss in the absence of any other abnormalities to explain the defect. Mean VF defects were classified with Glaucoma Staging System (GSS) 12 within stage 4. The pre-operative and 3-months and 6-months post-operative mean deviation (MD) and pattern standard deviation (PSD) indexes were used for the analysis.…”

Section: Study Proceduresmentioning

confidence: 99%

Short-term changes in the optic nerve head and visual field after trabeculectomy

Figus

Lazzeri

Nardi

et al. 2011

Eye

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Aims or Purpose To evaluate short-term changes in optic nerve head topography and visual field induced by surgical reduction of intraocular pressure. Methods A prospective study was performed on 56 eyes of 56 patients with uncontrolled primary open-angle glaucoma despite maximum medical therapy, which underwent trabeculectomy. Optic nerve head evaluations by means of Heidelberg Retina Tomograph, and visual field tests were performed pre-operatively, and at 3 and 6 months after surgery. Differences in intraocular pressure, visual field indices, and Heidelberg Retina Tomograph parameters were evaluated with the t-test for paired data. A linear regression model was calculated to analyze the relationship between intraocular pressure reduction and visual field changes, and optic nerve head changes. Results Mean intraocular pressure decreased from 24.4 ± 5.0 mm Hg to 12.1 ± 3.1 mm Hg (month 3, Po0.001), and 10.6±2.8 mm Hg (month 6, Po0.001) after trabeculectomy. Mean retinal nerve fiber layer thickness (baseline, 0.19±0.034; month 3, 0.24 ± 0.039, P ¼ 0.05; month 6, 0.21 ± 0.037, P ¼ 0.05) showed a statistical significant change compared with baseline values. Conclusions In this 6-months study, a significant increase in retinal nerve fiber layer thickness was detected after glaucoma filtration surgery.

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“…The difference between the averages of the two groups proved significant in checks made at 10.30 am, 3 pm and 5 pm. At the time of the first medical examination, the study of the visual field highlights impairment of the GSS2 [9], statistically more significant (p=0.001), in type A subjects (2.58±0.52) compared to those of type B (1.61±0.64).…”

Section: Discussionmentioning

confidence: 99%

Large diurnal variation of intraocular pressure in open angle glaucoma in subjects with type a behaviour pattern

Bubella¹,

Bubella²

2014

J Eye Ophthalmol

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Aim:To evaluate the possible causes of the greater perimetric damage found in OAG subjects with type A behaviour and the possible role of psycho-physiological stress. Materials and methods: 80 patients with OAG, 44 women and 36 men, 40 with type A behaviour and 40 with type B studied with the Type A/B Personality Questionnaire (A modified version of the Jenkins Activity Survey), underwent a complete ophthalmologic examination consisting of bio-microscopy, tonometry and daily tonometric curve, examination of the visual field by means of Octopus 1-2-3 computerised perimeter and its assessment with the Glaucoma Staging System 2 (GSS2), morphological monitoring of the Retinal Nerve Fibre Layer (RNFL) with GDxVCC and monitoring of arterial tension (times 8.30 am-10.30 am-12.30 pm-3 pm-5 pm and 7 pm) with a UA-1010 automatic Digital Blood Pressure Monitor device. Results: In subjects with type A behaviour fluctuation in IOP values is observed in the daytime hours in concomitance with similar oscillations in arterial pressure values. In the subjects with type B behaviour both IOP and the arterial pressure values remain more or less constant with oscillations that are not statistically significant. In GSS2 more significant impairment of the visual field is observed in subjects with type A behaviour. In the same subjects, GDxVCC examination shows statistically significant impairment of the values. The NFI index is positively correlated with the perimetric damage (r=0.74). Conclusions: Personality study is an extremely important part of the diagnostic work-up and treatment of OAG. The frequent oscillations in IOP observed in subjects with type A behaviour could constitute a risk factor in the evolution of perimetric damage.

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Enhanced Glaucoma Staging System (GSS 2) for Classifying Functional Damage in Glaucoma

Abstract: The GSS 2 was able to correctly classify both damage severity and perimetric defect type in the sample studied, using either the corrected or uncorrected visual field indices. It is a quick and easy method, and its formulas can be introduced in any software.

Cited by 195 publications

References 20 publications

Macular Function in Eyes with Open-Angle Glaucoma Evaluated by Multifocal Electroretinogram

Macular Function in Eyes with Open-Angle Glaucoma Evaluated by Multifocal Electroretinogram

Short-term changes in the optic nerve head and visual field after trabeculectomy

Large diurnal variation of intraocular pressure in open angle glaucoma in subjects with type a behaviour pattern

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