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Abstract #23353 Published in IGR 11-1
Glaucoma monitoring in a clinical setting: glaucoma progression analysis vs nonparametric progression analysis in the Groningen Longitudinal Glaucoma Study
Wesselink C; Heeg GP; Jansonius NMArchives of Ophthalmology 2009; 127: 270-274
OBJECTIVE: To compare prospectively 2 perimetric progression detection algorithms for glaucoma, the Early Manifest Glaucoma Trial algorithm (glaucoma progression analysis [GPA]) and a nonparametric algorithm applied to the mean deviation (MD) (nonparametric progression analysis [NPA]). METHODS: Patients with a reproducible glaucomatous visual field defect at baseline in at least 1 eye were followed up prospectively using perimetry (Humphrey field analyzer 30-2 Swedish interactive thresholding algorithm). Classifications by GPA and by NPA at the end of the follow-up period were compared. RESULTS: Two hundred twenty-one patients met the inclusion criteria; 1 eye per patient was analyzed. On average, 7.1 reliable fields were available after a mean follow-up period of 5.3 years. The mean MD at baseline was -9.4 dB; the mean MD slope during the follow-up period was -0.25 dB/y. Fifty-six eyes showed progression by GPA and 89 eyes by NPA (P < .001); 42 eyes showed progression by both techniques (kappa = 0.39). In eyes with progression detected by NPA only, baseline MD was worse than that in eyes with progression detected by GPA (-12.5 vs -8.2 dB, P = .002), and GPA more often gave a reading of "baseline MD out of range" (P < .001). After exclusion of eyes with baseline MD out of range, the measure of agreement was kappa = 0.50. CONCLUSIONS: Nonparametric progression analysis had fairly good agreement with GPA. Especially in cases of more advanced disease, NPA labeled more eyes as having progression than GPA.
Dr. C. Wesselink, Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
Classification:
6.20 Progression (Part of: 6 Clinical examination methods)
