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Abstract #18494 Published in IGR 3-3
Optic disc and visual field changes in a prospective longitudinal study of patients with glaucoma: comparison of scanning laser tomography with conventional perimetry and optic disc photography
Chauhan BC; McCormick TA; Nicolela MT; Leblanc RPAnnals of ophthalmology (Skokie, Ill.) 2001; 119: 1492-1499
OBJECTIVE: To investigate the relationship between optic disc changes measured with scanning laser tomography and those measured with conventional perimetry and optic disc photography. METHODS: In a prospective longitudinal study, 77 patients with early glaucomatous visual field damage were followed up. Scanning laser tomography (using the Heidelberg Retina Tomograph) and conventional perimetry (using the Humphrey Field Analyzer) were carried out every six months. Disc progression was determined by a procedure recently described by the authors for scanning laser tomography, with confirmed progression requiring repeatable changes based on probability limits for both the depth (using individual test-retest variability values) and size of change (determined in a group of 37 healthy individuals also followed up prospectively). Field progression was determined with the Statpac Glaucoma Change Probability Analysis. The agreement between scanning laser tomography and conventional disc photography was determined in a subgroup of patients. RESULTS: Patients were followed up for a median of 5.5 years, with a median of 12 sets of examinations with scanning laser tomography and conventional perimetry. Twenty-one patients (27%) showed no progression with either technique. Thirty-one patients (40%) progressed with scanning laser tomography only, while three (4%) progressed with conventional perimetry only. Of the 22 patients (29%) who progressed with both techniques, ten (45%) progressed with scanning laser tomography first (median, 18 months earlier) and nine (41%) with conventional perimetry first (median, 12 months earlier), while three (14%) progressed at the same time. Of the 16 patients with disc photographs that closely overlapped the follow-up, there was concordance between scanning laser tomography and disc photography in 13 patients (81%). CONCLUSIONS: Glaucomatous disc changes determined with scanning laser tomography occur more frequently than field changes. Most patients with field changes also had disc changes; however, less than half those with disc changes had field changes.
Dr B.C. Chauhan, Eye Care Centre, 2nd Floor, Centennial Building, 1278 Tower Road, Halifax, Nova Scotia, Canada B3H 2YS. bal@is.dal.ca
Classification:
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
