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Joseph Caprioli, Lilian Mohamed, Esteban Morales, Alessandro Rabiolo, Nathaniel Sears, Hirunpatravong Pradtana, Reza Alizadeh, Fei Yu, Abdelmonem A. Afifi, Anne L. Coleman, Kouros Nouri-Mahdavi; A Method to Measure the Rate of Glaucomatous Visual Field Change. Trans. Vis. Sci. Tech. 2018;7(6):14. https://doi.org/10.1167/tvst.7.6.14.
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© ARVO (1962-2015); The Authors (2016-present)
To develop a method to measure the rate of glaucomatous visual field (VF) deterioration and to identify fast progressors.
Retrospective, longitudinal, observational study of 8486 eyes of 4610 glaucomatous patients with ≥6 VFs and ≥3 years of follow-up. A Glaucoma Rate Index (GRI) was calculated. VF locations were partitioned into exponential decay or exponential improvement models. A pointwise rate of change (PRC) was estimated with an exponential fit and expressed as the percent/year change of the age- and location-matched normal perimetric range, presented as a spatially conserved VF map. PRCs were summed and normalized with boundary rates set by simulated decaying and improving VF series on a scale of −100 to +100, respectively.
A total of 89,704 VF examinations with 425,039 test location series was used. Median follow-up and number of VFs/eye were 9.7 years and 9 VFs, respectively. Initial and final mean deviations (±SD) were −4.2 (±5.2) and −5.7 (±6.4) dB. The proportions of test locations designated as decayed, improved, and unchanged were 13%, 4%, and 83%, respectively. Mean PRCs for decay, improvement, and no change were −3.7 (±4.7)%/y, 2.5 (±2.6)%/y, and −0.5 (±2.1)%/y, respectively. The number of eyes with negative and positive GRIs was 5802 (68%) and 2390 eyes (28%), respectively. The proportion of eyes defined as fast progressors was 6.8%.
GRI provides a robust measure of glaucomatous VF change, operates without discontinuity over the entire perimetric range, and can be used to identify fast progressors.
This study describes a novel method that can help the clinician to determine VF progression.
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