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      Comparing Glaucoma Progression on 24-2 and 10-2 Visual Field Examinations

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          Abstract

          Purpose

          To compare the rate of mean deviation (MD) change on 24-2 versus 10-2 VFs in treated glaucomatous eyes with 5 or more examinations.

          Methods

          In a retrospective study, 24-2 and 10-2 VFs of 131 glaucoma patients (167 eyes) who had undergone at least 5 VFs examinations during their follow-up were analyzed. All these patients had VF defects both on 24-2 and 10-2 VFs. Rates of MD change were calculated using best linear unbiased predictions (BLUP).

          Results

          Median age, MD on 24-2 VF at baseline, number of VFs performed during follow-up and follow-up duration were 55 years, -16.9 dB, 9 and 9 years respectively. Median rate of MD change was significantly greater (p<0.001) on 10-2 VF (-0.26 dB/year; interquartile range [IQR]: -0.47, -0.11) compared to 24-2 VFs (-0.19 dB/year; IQR: -0.41, -0.03). Comparing the rates of MD change in eyes with different severities of VF loss (early [MD better than -6 dB], moderate [-6 dB to -12 dB], advanced [-12 to -20 dB] and severe [MD worse than -20 dB]) at baseline (based on the MD on 24-2 VF), median rate of MD change was comparable between 10-2 and 24-2 VFs in mild (-0.45 dB/year vs. -0.40 dB/year, P = 0.42) and moderate (-0.32 dB/year vs. -0.40 dB/year, P = 0.26) VF loss categories, while the same were significantly greater on 10-2 VFs in advanced (-0.28 dB/year vs. -0.21 dB/year, P = 0.04) and severe (-0.18 dB/year vs. -0.06 dB/year, P<0.001) VF loss categories.

          Conclusions

          In patients with VF defects both on 24-2 and 10-2 VFs, evaluating the rate of MD change on 10-2 VFs may help in better estimation of glaucoma progression, especially so in eyes with advanced glaucoma at baseline.

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          Most cited references26

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          Predictive factors for glaucomatous visual field progression in the Advanced Glaucoma Intervention Study.

          To investigate the risk factors associated with visual field (VF) progression in the Advanced Glaucoma Intervention Study (AGIS) with pointwise linear regression (PLR) analysis of serial VFs. Prospective, multicenter, randomized clinical trial. Five hundred nine eyes of 401 patients from the AGIS with a baseline VF score of or=7 VF examinations, and >or=3 years of follow-up were selected. Visual field progression. This is a cohort study of patients enrolled in a prospective randomized clinical trial (AGIS). Worsening of a test location on PLR analysis was defined as a change of threshold sensitivity of >or=1.00 decibels a year, with P
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            A visual field index for calculation of glaucoma rate of progression.

            To present a new perimetric index for calculating the rate of glaucomatous progression and to compare its performance with the traditional mean deviation index (MDI). Experimental study describing a device and retrospective cohort study. We developed a new visual field index, the glaucoma progression index (GPI), intended to be less affected by cataract than the MDI by calculating age-corrected defect depth at test points identified as significantly depressed in pattern deviation probability maps. The valid operating range for pattern deviation analysis was estimated. When exceeding this range, the total deviation probability maps were used for identification of significantly depressed points. The GPI is expressed in percentage, where 100% represents a normal visual field and 0% represents a perimetrically blind field, and is plotted vs patient age. Rate of progression, presented as yearly change in the GPI, is calculated by linear regression analysis. We conducted a pilot evaluation in three groups of patients: 1) eyes with developing cataract, 2) eyes without cataract, and 3) eyes in which cataract surgery was performed in the middle of the series. The cut-off for pattern deviation was, at mean deviation, worse than -20 decibels (dB) in fields in which the eighty-fifth percentile of the total deviation value was significantly depressed. In the first group (n = 45), the measured rate of progression was greater with the MDI than with the GPI (P < .0001). The mean loss per year was 3.6%/year for the MDI and 2.1%/year for the GPI. In the second group (n = 42), the rate of progression did not differ between the MDI and the GPI (P = .52); the means were 2.7%/year and 2.6%/year, respectively. In the third group (n = 44), the confidence limits for the rate of progression were significantly smaller with the GPI than with the MDI (P = .04). Glaucoma progression rates calculated using the GPI seem to be considerably less affected by cataract and cataract surgery than rates based on the traditional MDI.
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              Prevalence and nature of early glaucomatous defects in the central 10° of the visual field.

              The macula is essential for visual functioning and is known to be affected even in early glaucoma. However, little is currently understood about the prevalence and nature of central vision loss in early glaucoma.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                15 May 2015
                2015
                : 10
                : 5
                : e0127233
                Affiliations
                [001]VST Glaucoma Center, L V Prasad Eye Institute, Hyderabad, India
                Sun Yat-sen University, CHINA
                Author notes

                Competing Interests: Dr. Rao is a consultant for Allergan and Dr. Garudadri is on the advisory board of Allergan, Merck and Alcon and has received research support from Optovue. Past financial disclosures are as follows: Rao HL: Allergan (C); Garudadri CS: Allergan (C), Merck (C), Alcon (C). There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

                Conceived and designed the experiments: HLR. Performed the experiments: HLR VUB DK AKM SS CSG. Analyzed the data: HLR. Contributed reagents/materials/analysis tools: HLR VUB DK AKM SS CSG. Wrote the paper: HLR. Nil.

                Article
                PONE-D-14-50077
                10.1371/journal.pone.0127233
                4433281
                25978316
                e9f86aea-36ea-4eb3-86a1-7f92f75fe030
                Copyright @ 2015

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

                History
                : 6 November 2014
                : 12 April 2015
                Page count
                Figures: 2, Tables: 4, Pages: 9
                Funding
                The authors declare funding from the following sources: Rao HL: Allergan (C); Begum VU: none; Khadka D: none; Mandal AK: none; Senthil S: none; Garudadri CS: Allergan (C), Merck (C), Alcon (C). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Custom metadata
                Institutional Review Board (IRB) restrictions make data unsuitable for public deposition. An anonymized data set will however be made available for researchers who meet the criteria for access to confidential data upon request to the corresponding author or the IRB.

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