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.
| Original language | English |
|---|---|
| Pages (from-to) | 196-205 |
| Number of pages | 10 |
| Journal | American Journal of Ophthalmology |
| Volume | 266 |
| Early online date | 27 May 2024 |
| DOIs | |
| Publication status | Published - Oct 2024 |
Bibliographical note
Publisher Copyright:© 2024 The Authors
Funding
Funding/Support: Teresa C. Chen has received funding from Fidelity Charitable Fund (Harvard University), National Institutes of Health (NIH) R01 EB033321, NIH R44 EY034409, NIH UG1 EY033703, Alcon Laboratories, NIH UL1 RR025758, Massachusetts Lions Eye Research Fund, American Glaucoma Society Mid-Career Award. The sponsors or funding organizations had no role in the design or conduct of this research. Johannes F. de Boer has received funding from the Dutch Science Foundation for research projects related to endoscopy and ophthalmology, and from the Netherlands Organisation for Applied Scientific Research (TNO) for contract research on scanning laser ophthalmoscopes. Financial Disclosures: Johannes F. de Boer was chair of the Scientific Advisory Board of the center for Biomedical Optical Coherence Tomography Research and Translation (Harvard Medical School). Massachusetts General Hospital Corporation has licensed his IP to NIDEK Inc. Terumo Corporation, SpectraWave, and Heidelberg Engineering. Sponsored research Heidelberg Engineering, GmbH, Germany; Ninepoint Medical, Cambridge, MA. He has received payments as an expert witness for a UK law firm, received travel reimbursement for a PhD defence committee in France, has planned patents on polarization sensitive OCT, and has a diversified investment portfolio. Acknowledgments: None. Johannes F. de Boer has received funding from the Dutch Science Foundation for research projects related to endoscopy and ophthalmology, and from the Netherlands Organisation for Applied Scientific Research (TNO) for contract research on scanning laser ophthalmoscopes. b. Financial Disclosures: Johannes F. de Boer was chair of the Scientific Advisory Board of the Center for Biomedical Optical Coherence Tomography Research and Translation (Harvard Medical School). Massachusetts General Hospital Corporation has licensed his IP to NIDEK Inc., Terumo Corporation, SpectraWave, and Heidelberg Engineering. Sponsored research Heidelberg Engineering, GmbH, Germany; Ninepoint Medical, Cambridge, MA . He has received payments as an expert witness for a UK law firm, received travel reimbursement for a PhD defense committee in France, has planned patents on polarization sensitive OCT, and has a diversified investment portfolio. c. Other Acknowledgements: None a. Funding/Support: Teresa C. Chen has received funding from Fidelity Charitable Fund (Harvard University), National Institutes of Health (NIH) R01 EB033321 , NIH R44 EY034409 , NIH UG1 EY033703 , Alcon Laboratories , NIH UL1 RR025758 , Massachusetts Lions Eye Research Fund, American Glaucoma Society Mid-Career Award. The sponsors or funding organizations had no role in the design or conduct of this research.
| Funders | Funder number |
|---|---|
| Massachusetts Lions Eye Research Fund | |
| Netherlands Organisation for Applied Scientific Research | |
| Nederlandse Organisatie voor Wetenschappelijk Onderzoek | |
| Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek | |
| Harvard Medical School | |
| NIDEK Inc | |
| American Glaucoma Society | |
| Fidelity Charitable Fund | |
| Heidelberg Engineering | |
| Dutch Science Foundation | |
| TNO | |
| NIH | R44 EY034409, R01 EB033321, UG1 EY033703 |
| National Institutes of Health | R44 EY034409, R01 EB033321, UG1 EY033703 |
| Alcon Laboratories | UL1 RR025758 |