Predicting Vision-Related Disability in Glaucoma

Abstract

A new methodology for classification and analysis of change in patient-reported quality-of-life outcomes allowed construction of models for predicting vision-related disability in glaucoma.

Comparison of Visual Field Point-Wise Event-Based and Global Trend-Based Analysis for Detecting Glaucomatous Progression

“…This is especially valuable because an increasing body of evidence has revealed the importance of the velocity of visual field loss, in addition to the level of loss itself, on functional disability. 24 – 31 …”

Improving the Feasibility of Glaucoma Clinical Trials Using Trend-Based Visual Field Progression End Points

“…Furthermore, a recent review also supported the use of rate of visual field MD change 9 as an outcome measure given the growing body of evidence that underscores the importance of both the level and rate of visual field loss on functional disability. [10][11][12][13][14][15][16][17] Although those previous sample size estimates 3 provided a useful initial indication on the feasibility of such short-term trials, further refinements to those estimates are required to better reflect what to expect in real-world clinical trials. For instance, the previous sample size estimates 3 were derived using rates of visual field change from a study reporting on the natural history of glaucoma, 18 assuming that the rates of change in a treated population were simply a percentage of those natural history rates.…”

Reply

“…REPLY: My colleagues and I thank Dr Grassi et al for their interest and for the opportunity of clarifying aspects of our study. 1 It is important to note, contrary to what Grassi et al mention, our study was not cross-sectional, but rather a longitudinal cohort study where patients had visual field tests and quality-of-life questionnaires assessed over time. Grassi et al make the valid point that perhaps the use of Swedish interactive threshold algorithm 30-2 visual fields would have provided additional information regarding the visual field losses of the patients and their relationship with quality of life over time, as compared with the 24-2 field.…”

“…We thank again Grassi et al for their interest in our study and for their insightful questions. Re: Lindén et al: Normal-tension glaucoma has normal intracranial pressure: a prospective study of intracranial pressure and intraocular pressure in different body positions (Ophthalmology. 2018;125:361e368) TO THE EDITOR: We appreciate the methodologic effort presented in the article by Lindén et al, 1 in which they prospectively evaluated the intracranial pressure (ICP) and adjusted translaminar cribrosa pressure difference (TLCPD) in patients with normal-tension glaucoma (NTG) compared with healthy controls. The article describes simultaneous measurement of ICP and intraocular pressure, along with calculated TLCPD, in 13 patients with NTG with documented visual field deficits compared with 11 controls across a series of postural changes.…”