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Enhancing Detection of Glaucoma Progression: Utility of 24-2 Visual Field Central Points vs. 10-2 Visual Fields. | LitMetric
Purpose : To test the hypothesis that a summary index derived from the central 12 points of the 24-2 visual field (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: 125 eyes (125 patients) with central damage or moderate to severe glaucoma from the Advanced Glaucoma Progression Study with four or more pairs of 10-2 and 24-2 SITA standard VFs.Methods : Baseline 10-2 and 24-2 VF dates were within six months, and the remaining pairs of VF tests were done in the same session. The MD12 index was calculated by averaging total deviation (TD) 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 rates of change.Results : The average (SD) 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 3 summary indices were highly correlated at baseline: r (95% CI) =0.62 (0.52-0.74) between 10-2 MD and 24-2 MD, 0.84 (0.78-0.90) between MD12 and 24-2 MD, and 0.86 (0.80-0.92) between 10-2 MD and MD12. The corresponding correlations between RoC were weaker: r=0.41 (0.37-0.45), 0.80 (0.78-0.82), and 0.49 (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 rates of change 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.
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