The groningen longitudinal glaucoma study III. The predictive value of frequency-doubling perimetry and GDx nerve fibre analyser test results for the development of glaucomatous visual field loss

Abstract

Purpose To investigate whether frequencydoubling perimetry (FDT) and nerve fibre analyser (GDx) test results are able to predict glaucomatous visual field loss in glaucoma suspect patients. Methods A large cohort of glaucoma suspect patients (patients with ocular hypertension or a positive family history of glaucoma without visual field abnormalities at baseline) was followed prospectively for 4 years with SAP (HFA 30-2 SITA fast), FDT (C-20 full threshold), and GDx (version 2.010) in a clinical setting. After the follow-up period, baseline FDT and GDx test results of converters (glaucoma suspect patients who had converted to a reproducible abnormal SAP test result during follow-up) were compared to that of non-converters (suspects with normal SAP test results at the end of the follow-up) by calculating relative risks. Cutoff point for FDT was 41 depressed test point Po0.01 in the total deviation probability plot; cutoff point for GDx was the number 429. Results Of 174 glaucoma suspect patients, 26 had developed reproducible glaucomatous visual field loss (conversion rate: 3.7% per year). Relative risk was 1.8 (95% confidence interval: 0.9-3.7; P ¼ 0.10) for FDT and 2.7 (95% confidence interval: 1.2-6.3; P ¼ 0.01) for GDx. Positive predictive value was 0.22 for both FDT and GDx; negative predictive value was 0.88 for FDT and 0.92 for GDx. Conclusions In a clinical setting, especially GDx may be helpful for identifying glaucoma suspect patients at risk of developing glaucomatous visual field loss as assessed by SAP.

Structural and Functional Progression in the Early Manifest Glaucoma Trial

“…38–42 The evidence of the role of imaging devices to predict visual field loss is conflicting. Several studies with up to eleven years of follow up showed promising ability to predict visual field loss among glaucoma suspects, 43–48 and possibly also in glaucoma patients, 49 while several other studies reported rather poor predictive ability 2, 3, 9, 12, but none with follow up longer than six years. There are also indications that the agreement between visual field progression and progression in optic disc photographs may be better than that between optic disc photographs and automated imaging results.…”

Predicting Progression in Glaucoma Suspects With Longitudinal Estimates of Retinal Ganglion Cell Counts

“…Several other methods to combine structure and function in glaucoma have been described in the literature. [6][7][8][26][27][28][29] A previous study by Boland and Quigley described a different method to combine structure and function in a single index, based on the calculation of probability of abnormality for each point in the visual field and for each sector of the optic disc using confocal scanning laser ophthalmoscopy. 30 The method showed a better performance than the structural parameters evaluated by confocal scanning laser ophthalmoscopy, but had a performance only similar to visual field global indexes.…”

“…[4][5][6] Although different structural and functional parameters have been shown to have predictive ability, few attempts have been made to apply a combination of these parameters to improve prediction of damage. 7,8 Due to the different characteristics of structural and functional tests, it is possible that a combined approach could perform better than the isolated use of structural or functional tests.…”

Topographic relationship between frequency‐doubling technology threshold values

“…Morphologic and functional tests are now commonly used together to diagnose glaucoma and to follow up glaucomatous patients (Heeg & Jansonius 2009; Horn et al. 2011).…”