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Abstract #21929 Published in IGR 10-4
Monitoring glaucoma progression
Brusini PProgress in Brain Research 2008; 173: 59-73
Monitoring progression is fundamental in managing patients with chronic open-angle glaucoma, which is as important as an early diagnosis of the disease. It is essential that both structural and functional damage be considered, in order to assure a complete and reliable assessment of progression. The optic disc and retinal nerve fiber layer damage can be evaluated using either low-tech (slit lamp biomicroscopy with a 78-diopter lens) or high-tech (HRT, OCT, GDx) methods; the latter providing a more objective and standardized analysis. The current gold standard in detecting functional damage is using standard automated perimetry (SAP). Different approaches can be used to assess SAP progression: (1) clinical judgment; (2) defect classification systems; (3) trend analysis; and, (4) event analysis. Several statistical programs are currently available to assist the ophthalmologist in the difficult task of assessing progression. Clinically relevant progression should only be considered when the change - be it structural and/or functional - is statistically significant, reproducible, and indicative of glaucomatous damage.
Dr. P. Brusini, Department of Ophthalmology, Santa Maria della Misericordia Hospital, Udine (Italy), Piazzale S. Maria della Misericordia, 15, 33100 Udine, Italy. brusini@libero.it