Although most glaucoma patients and suspects under routine care had slow rates of progression, a substantial proportion had rates that could potentially result in major ocular consequences if sustained over time, a recent study suggests.
This retrospective study evaluated 29,548 spectral-domain OCT (SD-OCT) and 19,812 perimetry images of 6,138 eyes of 3,669 patients.
The team observed average rates of change of -0.73±0.80μm/year for global retinal nerve fiber layer thickness and -0.09±0.36dB/year for perimetry mean deviation. They classified 26.6% and 9.1% of eyes as having at least a moderate rate of change and 31.6% and 26.5% as progressing at moderate or faster rates based on SD-OCT and visual fields, respectively. They noted that most eyes classified as fast by SD-OCT were classified as slow by perimetry and vice-versa.
“Both structural and functional tests should be used to monitor glaucoma, and SD-OCT still has a relevant role in detecting fast progressors in advanced disease,” the study authors concluded in their paper.
|Jammal AA, Thompson AC, Mariottoni EB, et al. Rates of glaucomatous structural and functional change from a large clinical population: the Duke Glaucoma Registry Study. Am J Ophthalmol. May 23, 2020. [Epub ahead of print].|