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Abstract #82514 Published in IGR 20-4
Making a Correct Diagnosis of Glaucoma: Data From the EMGT
Öhnell H; Bengtsson B; Heijl AJournal of Glaucoma 2019; 28: 859-864
: PRéCIS: A correct diagnosis of glaucoma established at initial visits. PURPOSE: It has been suggested that a diagnosis of glaucoma cannot be certain until progression has been demonstrated. Our aim was to evaluate the correctness of a glaucoma diagnosis established after 2 initial visits. PATIENTS AND METHODS: Patients included in the Early Manifest Glaucoma Trial (EMGT) who had continued follow-up for at least 15 years were included in this analysis. The patients had been recruited primarily through a population screening and were diagnosed with glaucoma if the Glaucoma Hemifield Test was outside normal limits in the same sector at two consecutive visits. A Glaucoma Hemifield Test classification of borderline was also diagnostic if corresponding optic disc findings were present. At least one of the following criteria had to be fulfilled during follow-up to confirm the initial diagnosis: (1) visual field progression in at least one eye according to the EMGT criterion; (2) development of manifest glaucoma in an initially ineligible fellow eye; (3) optic disc progression in at least one eye; (4) optic disc hemorrhages in at least 1 eye. RESULTS: Of the 255 patients included in the EMGT, 117 were followed for at least 15 years, representing 147 eyes eligible for our study. During follow-up, 134 eyes (91%) showed visual field progression, and, of the remaining 13 eyes, only 4 (3%) did not fulfill any of the criteria to confirm the diagnosis. CONCLUSIONS: A diagnosis made applying strict criteria to 2 initial visual field tests, supported by optic disc findings if visual field findings were borderline, was almost always correct.
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Classification:
6.6.1 Conventional manual (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
6.20 Progression (Part of: 6 Clinical examination methods)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
9.4.10 Glaucomas associated with hemorrhage (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)