Donald C Hood1, Sol La Bruna2, Emmanouil Tsamis2, Ari Leshno3, Bruna Melchior4, Jennifer Grossman5, Jeffrey M Liebmann6, Carlos Gustavo De Moraes6. 1. Department of Psychology, Columbia University, New York, New York; Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York. Electronic address: dch3@columbia.edu. 2. Department of Psychology, Columbia University, New York, New York. 3. Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York; Sackler Faculty of Medicine, Department of Ophthalmology, Tel Aviv University, Tel Aviv, Israel. 4. Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York; Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. 5. SUNY Downstate College of Medicine, Brooklyn, New York. 6. Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York.
Abstract
PURPOSE: To better understand the efficacy of the 24-2 guided progression analysis (GPA) in the detection of progression in eyes with early glaucoma (i.e., 24-2 mean deviation [MD] better than -6 dB) by comparing 24-2 GPA with a reference standard (RS) based on a combination of OCT and 24-2 and 10-2 visual field (VF) information. DESIGN: Cross-sectional study. PARTICIPANTS: Ninety-nine eyes from 99 individuals, including 70 suspected or early glaucomatous eyes (24-2 MD better than -6 dB) and 29 healthy controls (HCs). METHODS: All the eyes had at least 4 OCT and VF test dates over a period that ranged from 12 to 59 months. The 24-2 VF tests included 2 baseline tests and at least 2 follow-up tests. The 2 baseline tests were performed within an average of 5.6 days (median, 7 days), and the last follow-up test was performed at least 1 year after the first baseline visit. MAIN OUTCOME MEASURES: A commercial 24-2 GPA software, with default settings, characterized the eyes as having "likely progression" (LP) or "possible progression" (PP); both were considered "progressing" for this analysis. For RS, 3 authors graded progression using strict criteria and a combination of a custom OCT progression report and commercial 24-2 and 10-2 GPA reports for the same test dates as GPA. RESULTS: The reference standard identified 10 (14%) of the 70 patient eyes and none of the HC eyes as having progression. The 24-2 guided progression analysis identified 13 of the 70 patient eyes as having progression (PP or LP). However, it correctly classified only 4 (40%) of the 10 RS progressors. All 6 of the RS progressors missed by the 24-2 GPA showed progression in the macula. In addition, the 24-2 GPA identified 2 of the 29 HC eyes as progressors and 9 patient eyes without progression based on the RS. CONCLUSIONS: In eyes with early glaucoma (i.e., 24-2 MD, > -6 dB) in this study, the 24-2 GPA missed progression seen using OCT and exhibited a relatively high rate of false positives. Furthermore, the region progressing typically included the macula. The results suggest that including OCT and/or 10-2 VFs should improve the detection of progression.
PURPOSE: To better understand the efficacy of the 24-2 guided progression analysis (GPA) in the detection of progression in eyes with early glaucoma (i.e., 24-2 mean deviation [MD] better than -6 dB) by comparing 24-2 GPA with a reference standard (RS) based on a combination of OCT and 24-2 and 10-2 visual field (VF) information. DESIGN: Cross-sectional study. PARTICIPANTS: Ninety-nine eyes from 99 individuals, including 70 suspected or early glaucomatous eyes (24-2 MD better than -6 dB) and 29 healthy controls (HCs). METHODS: All the eyes had at least 4 OCT and VF test dates over a period that ranged from 12 to 59 months. The 24-2 VF tests included 2 baseline tests and at least 2 follow-up tests. The 2 baseline tests were performed within an average of 5.6 days (median, 7 days), and the last follow-up test was performed at least 1 year after the first baseline visit. MAIN OUTCOME MEASURES: A commercial 24-2 GPA software, with default settings, characterized the eyes as having "likely progression" (LP) or "possible progression" (PP); both were considered "progressing" for this analysis. For RS, 3 authors graded progression using strict criteria and a combination of a custom OCT progression report and commercial 24-2 and 10-2 GPA reports for the same test dates as GPA. RESULTS: The reference standard identified 10 (14%) of the 70 patient eyes and none of the HC eyes as having progression. The 24-2 guided progression analysis identified 13 of the 70 patient eyes as having progression (PP or LP). However, it correctly classified only 4 (40%) of the 10 RS progressors. All 6 of the RS progressors missed by the 24-2 GPA showed progression in the macula. In addition, the 24-2 GPA identified 2 of the 29 HC eyes as progressors and 9 patient eyes without progression based on the RS. CONCLUSIONS: In eyes with early glaucoma (i.e., 24-2 MD, > -6 dB) in this study, the 24-2 GPA missed progression seen using OCT and exhibited a relatively high rate of false positives. Furthermore, the region progressing typically included the macula. The results suggest that including OCT and/or 10-2 VFs should improve the detection of progression.
Authors: Carlos Gustavo De Moraes; Jayter Silva Paula; Dana M Blumberg; George A Cioffi; Lama A Al-Aswad; Christopher A Girkin; Robert N Weinreb; Linda M Zangwill; Robert Ritch; Remo Susanna; Donald C Hood; Jeffrey M Liebmann Journal: Am J Ophthalmol Date: 2020-04-09 Impact factor: 5.258
Authors: Carlos Gustavo De Moraes; Ashley Sun; Ravivarn Jarukasetphon; Rashmi Rajshekhar; Lynn Shi; Dana M Blumberg; Jeffrey M Liebmann; Robert Ritch; Donald C Hood Journal: JAMA Ophthalmol Date: 2019-02-01 Impact factor: 7.389
Authors: Donald C Hood; Ali S Raza; Carlos Gustavo V de Moraes; Jeffrey G Odel; Vivienne C Greenstein; Jeffrey M Liebmann; Robert Ritch Journal: Invest Ophthalmol Vis Sci Date: 2011-02-16 Impact factor: 4.799
Authors: Ko Eun Kim; Ki Ho Park; Beong Wook Yoo; Jin Wook Jeoung; Dong Myung Kim; Hee Chan Kim Journal: Invest Ophthalmol Vis Sci Date: 2014-05-06 Impact factor: 4.799
Authors: V T Diaz-Aleman; A Anton; M Gonzalez de la Rosa; Z K Johnson; S McLeod; A Azuara-Blanco Journal: Br J Ophthalmol Date: 2008-07-11 Impact factor: 4.638
Authors: Emmanouil Tsamis; Nikhil K Bommakanti; Ashley Sun; Kaveri A Thakoor; Carlos Gustavo De Moraes; Donald C Hood Journal: Transl Vis Sci Technol Date: 2020-03-18 Impact factor: 3.283