Enhancing Detection of Glaucoma Progression

IF 2.8 Q1 OPHTHALMOLOGY

Ophthalmology. Glaucoma Pub Date : 2025-03-01 DOI:10.1016/j.ogla.2024.11.004

Maryam Ashrafkhorasani MD , Sajad Besharati MD , Vahid Mohammadzadeh MD , Jane Zou BS , Judy Figueroa BS , Masood Mohammadi MD , Kouros Nouri-Mahdavi MD, MS

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Abstract

Purpose

To test the hypothesis that a summary index derived from the central 12 points of the 24-2 visual field (12-point mean deviation [MD12]) could provide complementary information to that provided by the 24-2 visual field (VF) mean deviation (24-2 MD).

Design

Longitudinal observational study.

Participants

One hundred twenty-five eyes (125 patients) with central damage or moderate to severe glaucoma from the Advanced Glaucoma Progression Study with ≥ 4 pairs of 10-2 and 24-2 Swedish Interactive Thresholding Algorithm standard VFs.

Methods

Baseline 10-2 and 24-2 VF dates were within 6 months, and the remaining pairs of VF tests were done in the same session. The MD12 index was calculated by averaging total deviation values from the central 12 points of 24-2 VF. Simple linear regression of MD against time was used to estimate 24-2 MD, 10-2 MD, and MD12 rates of change (RoC). Progression at the final follow-up visit was defined as a RoC < 0 dB/year with P < 0.05 for any summary index with confirmation.

Main Outcome Measures

Proportion of progressing eyes based on 24-2 MD, 10-2 MD, and MD12 RoC.

Results

The average (standard deviation) baseline 24-2 and 10-2 MD were −9.0 ± 6.2 and −8.5 ± 5.4 dB, respectively. The mean follow-up time was 5.7 (±1.6) years. The three summary indices were highly correlated at baseline: r = 0.62 (95% confidence interval: 0.52–0.74) between 10-2 MD and 24-2 MD, 0.84 (95% confidence interval: 0.78–0.90) between MD12 and 24-2 MD, and 0.86 (95% confidence interval: 0.80–0.92) between 10-2 MD and MD12. The corresponding correlations between RoC were weaker: r = 0.41 (95% confidence interval: 0.37–0.45), 0.80 (95% confidence interval: 0.78–0.82), and 0.49 (95% confidence interval: 0.45–0.53). Glaucoma progression was detected in 29 (23.2%), 22 (17.6%), and 23 eyes (18.4%) based on the 24-2, 10-2, and MD12 RoC, respectively; 7 eyes (9.6%) exhibited progression based on MD12 RoC and not with 24-2 MD; only 3 of these eyes progressed according to 10-2.

Conclusions

MD12 RoC and detection rates have a low level of agreement with those of 10-2 and hence do not replace the need for 10-2 VF MD to monitor central damage.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

查看原文本刊更多论文

加强青光眼进展的检测：24-2 视野中心点与 10-2 视野的实用性对比。

目的：验证一个假设，即从24-2视野中心12点（MD12）得出的汇总指数可以提供24-2视野（VF）平均偏差（24-2 MD）所提供信息的补充：纵向观察研究参与者：125 只患有中心性损害或中重度青光眼的眼睛（125 名患者），这些眼睛来自晚期青光眼进展研究（Advanced Glaucoma Progression Study），具有四对或四对以上的 10-2 和 24-2 SITA 标准 VF：基线 10-2 和 24-2 VF 日期均在 6 个月内，其余几对 VF 测试在同一疗程中完成。MD12 指数通过计算 24-2 VF 中心 12 个点的总偏差 (TD) 值的平均值得出。MD 与时间的简单线性回归用于估算 24-2 MD、10-2 MD 和 MD12 的变化率 (RoC)。主要结果测量指标：根据 24-2 MD、10-2 MD 和 MD12 变化率计算的进展眼比例：平均（标清）基线 24-2 MD 和 10-2 MD 分别为 -9.0 ± 6.2 和 -8.5 ± 5.4 dB。平均随访时间为 5.7 (±1.6) 年。基线时的 3 个汇总指数高度相关：10-2 MD 和 24-2 MD 之间的 r (95% CI) =0.62 (0.52-0.74)，MD12 和 24-2 MD 之间的 r (0.84 (0.78-0.90)，10-2 MD 和 MD12 之间的 r (0.86 (0.80-0.92)。RoC 之间的相应相关性较弱：r=0.41（0.37-0.45）、0.80（0.78-0.82）和 0.49（0.45-0.53）。根据 24-2、10-2 和 MD12 RoC，分别有 29 眼（23.2%）、22 眼（17.6%）和 23 眼（18.4%）检测到青光眼进展；根据 MD12 RoC 而非 24-2 MD，有 7 眼（9.6%）显示青光眼进展；其中只有 3 眼根据 10-2 检测到青光眼进展：结论：MD12的变化率和检出率与10-2的变化率和检出率的一致性较低，因此不能取代10-2 VF MD来监测中央损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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