16 August 2014
Posted in Pearls in Ophthalmology
By Brooke Strickland
In this study, researchers wanted to develop new parameters to monitor glaucoma progression. The visual field index (VFI) summarizes global visual field (VF) data and was used to monitor glaucoma progression using 24-2 and 30-2 methods. The same types of principles were used in this study in order to develop new parameters in the central field index (CFI) and monitor 10-2 VF progression. There were 142 patients included in the study (176 eyes).
For the study, researchers looked at glaucoma patients with paracentral defects seen on 24-2 perimetry and followed up with at least 5 10-2 VF tests. The CFI was created by calculating age-corrected defect depth at test points gathered during 10-2 exams. The sensitivities at these points were scored as percentages similar to the method described for the VFI. A weighting procedure was used based on published estimates of the occipital cortical spatial magnification. For validation, reserachers completed mixed linear model testing for the link between CFI rates of change (%/year) and identified risk factors for glaucoma progression in a population with established glaucoma and at least 5 10-2 VF tests. To determine whether the CFI was affected by cataract, as is known to occur with mean deviation (MD), they conducted a pilot evaluation comparing rates of CFI change in 3 groups. The first group had eyes with cataract, the second group had pseudophakic eyes, and the last group had eyes in which cataract surgery was performed in the middle of the series.
Results showed that the average rate of CFI change of the entire sample was −1.10%/year. Elevated intraocular pressure was linked significantly with faster CFI change, whereas lens status did not influence CFI rates of change. (1)
What to take away from the study: The new index system that researchers created to monitor glaucoma progression showed that central field progression that is slightly affected by the presence or removal of cataract and that relates significantly with an important risk factor for glaucoma progression. This new index may prove helpful for glaucoma management.
1.Gustavo de Moraes, Carlos, MD, Furlanetto, Rafael, L., MD, Ritch, Robert, MD, Liebmann, Jeffrey, M., MD. “A New Index to Monitor Central Visual Field Progression in Glaucoma.” Ophthalmology. Volume 121, Issue 8, Pages 1531-1538. Manuscript no. 2013-1407. Published online August 9, 2014. Accessed online August 13, 2014. http://www.aaojournal.org/article/S0161-6420%2814%2900135-3/abstract
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