Frequency of Agreement Between Structural and Functional Glaucoma Testing: A Longitudinal Study of 3D OCT and Current Clinical Tests.
Manik Dhruv, Ratanawongphaibul Kitiya, Kim Janice, Tsikata Edem, Lee Hang, Margeta Milica A, Ondeck Courtney L, De Boer Johannes F, Chen Teresa C
AI Summary
This study found structural and functional glaucoma tests rarely detect progression simultaneously. Clinically, this means progression is often observed by only one or two tests at a given visit.
Abstract
Purpose
To evaluate how often tests of structure and function detect glaucoma progression at the same study visit. Tests include current glaucoma clinical tests and a new 3-dimensional (3D) optical coherence tomography (OCT) rim measurement.
Design
Prospective cohort study.
Methods
For 124 open-angle glaucoma patients at a single institution, one eye was randomly selected for each patient. Patients were included if they had open-angle glaucoma and if they had at least 4 yearly study visits. Study visits included a full dilated eye exam, disc photography (DP), Humphrey visual field (HVF 24-2) testing, 2D OCT retinal nerve fibre layer (RNFL) thickness measurements, and 3D OCT neuroretinal rim measurements (i.e., minimum distance band or MDB). For each test at each study visit, eyes were classified as progressors or non-progressors using event-based analysis. Agreement occurred if tests progressed in the same eye at the same study visit. Agreements between all compared tests were calculated as percentages of agreement.
Results
The study included 124 open-angle glaucoma eyes, which had an average follow-up period of 66.9 ± 16.4 months. Structural tests (i.e., DP, global RNFL thickness, and global MDB rim thickness) progressed at the same visit as the functional test (i.e., HVF testing) in only 5.0% (3/60) to 16.0% (13/81) of eyes. Global MDB thickness and global RNFL thickness showed similar agreement with functional HVF testing (i.e., 16.0% [13/81] and 8.3% [7/84], respectively), and global MDB thickness showed better structure-function agreement with HVF testing than between DP and HVF testing (i.e., 5.0% [3/60], P = 0.04). For all paired comparisons between testing methods, eyes with moderate glaucoma showed similar or better agreement than eyes with mild or severe glaucoma.
Conclusions
Clinical tests of structure and function do not usually progress at the same clinic visit. Most of the time, glaucoma progression is only detected by one or two tests.
MeSH Terms
Shields Classification
Key Concepts5
Structural tests (disc photography, global retinal nerve fibre layer thickness, and global minimum distance band rim thickness) progressed at the same visit as the functional test (Humphrey visual field testing) in only 5.0% (3/60) to 16.0% (13/81) of open-angle glaucoma eyes.
Global minimum distance band (MDB) thickness showed similar agreement with functional Humphrey visual field testing (16.0% [13/81]) and global retinal nerve fibre layer (RNFL) thickness (8.3% [7/84]) in open-angle glaucoma eyes.
Global minimum distance band (MDB) thickness showed better structure-function agreement with Humphrey visual field (HVF) testing than between disc photography (DP) and HVF testing (5.0% [3/60], P = 0.04) in open-angle glaucoma eyes.
For all paired comparisons between testing methods, open-angle glaucoma eyes with moderate glaucoma showed similar or better agreement than eyes with mild or severe glaucoma regarding progression.
Clinical tests of structure and function for glaucoma do not usually progress at the same clinic visit; most of the time, glaucoma progression is only detected by one or two tests.
Related Articles5
Detection of glaucoma progression on longitudinal series of en-face macular optical coherence tomography angiography images with a deep learning model.
Cohort StudyOptic Disc Microvasculature Reduction and Visual Field Progression in Primary Open-Angle Glaucoma.
Case SeriesDecreased macular deep capillary plexus is associated with functional progression of normal tension glaucoma patients with unilateral visual field loss.
Longitudinal StudyLongitudinal changes in optical coherence tomography angiography characteristics in normal-tension glaucoma with or without high myopia.
Cohort StudyRelationship Between Retinal Oxygen Saturation and the Severity of Visual Field Damage in Glaucoma.
Cross-Sectional StudyIs this article assigned to the wrong chapter(s)? Let us know.