scholarly journals Global Glaucoma Staging System (GGSS): A New Method to Simultaneously Assess the Severity of Both Functional and Structural Damage in Glaucoma

2021 ◽  
Vol 10 (19) ◽  
pp. 4414
Author(s):  
Paolo Brusini
Keyword(s):  
Visual Field ◽  
Structural Damage ◽  
Open Angle Glaucoma ◽  
Visual Fields ◽  
Staging System ◽  
Normal Subjects ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Spectral Domain Oct

Background: The classification of damage in glaucoma is usually based either on visual field or optical coherent tomography (OCT) assessment. No currently available method is able to simultaneously categorize functional and structural damage. Material and Methods: In this study, 283 patients with chronic open-angle glaucoma (OAG) at different stages and 67 healthy subjects were tested with both standard automated perimetry and spectral domain OCT for retinal nerve fiber layer (RNFL) assessment. The visual field data were classified using the Glaucoma Staging System 2, whereas OCT results were processed with the OCT Glaucoma Staging System. These data were used to create a new staging system (global glaucoma staging system, GGSS), in which the severity of visual field and RNFL damage is reported on the Y and X axis, respectively. The GGSS was tested in a different sample of 147 patients with manifest OAG, 56 with preperimetric glaucoma and 43 normal subjects. A six-stage clinical classification, based on the analysis of visual fields and optic disc appearance, was used as gold standard. Results: The GGSS was able to correctly classify in the same stage or within the immediately adjacent stages 145 cases on 147 (98.6%). Fifty-four preperimetric cases (96.4%) were classified as borderline or abnormal (Stage 1 or 2). Here, 41 normal eyes out of 43 were correctly classified as Stage 0, with a specificity of 95.3%. Conclusions: Preliminary results from this study are encouraging and suggest that the new GGSS is able to provide information concerning the severity of structural and functional damage in an integrated manner.

Ocular Hypertension and Corneal Thickness: A Long-Term Prospective Study. Results after Two Years

2005 ◽  
Vol 15 (5) ◽  
pp. 550-555 ◽  
Author(s):  
P. Brusini ◽  
C. Tosoni ◽  
L. Parisi ◽  
L. Rizzi
Keyword(s):  
Visual Field ◽  
Ocular Hypertension ◽  
Corneal Thickness ◽  
Normal Subjects ◽  
Continuous Variable ◽  
Control Group ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Study Results

Purpose To study the importance of the central corneal thickness (CCT) in patients with ocular hypertension in a 2-year follow-up. Methods A total of 110 subjects with ocular hypertension (intraocular pressure [IOP] >21 mmHg and normal automated visual field test) were admitted to the study. All patients periodically underwent the following tests: 1) circadian IOP curve; 2) standard automated perimetry (SAP, Humphrey 30–2 SITA test); 3) short wavelength automated perimetry (SWAP); 4) frequency doubling technology perimetry (FDT, N-30 threshold test); 5) nerve fiber layer analysis with GDx; 6) ibopamine test; 7) ultrasonic pachymetry. Patients were divided into three groups, based on corneal thickness. The frequency of abnormal tests within these groups was evaluated with the Pearson's χ2 test. Baseline IOP was corrected using the Doughty and Zaman formula. CCT was also considered as a continuous variable. A control group of 48 normal subjects was also considered. Results The mean CCT was 562.8 um ± 37.7. The difference with respect to normal subjects was statistically significant (p<0.01). Using the correction formula, 43 eyes (39.1%) had an IOP <21 mmHg. Abnormal test results were more frequently found with FDT. The percentage of abnormal results was found to be inversely proportional to CCT. The other tests gave inconsistent or conflicting results. Using the values of CCT as a continuous variable, no significant association was found with the GDx number and the visual field indices. Conclusions The results of our 2-year study confirm the importance of CCT measurement in the evaluation of the risk of developing glaucomatous damage.

scholarly journals Optic Disc Vascularization in Glaucoma: Value of Spectral-Domain Optical Coherence Tomography Angiography

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Pierre-Maxime Lévêque ◽  
Pierre Zéboulon ◽  
Emmanuelle Brasnu ◽  
Christophe Baudouin ◽  
Antoine Labbé
Keyword(s):  
Visual Field ◽  
Univariate Analysis ◽  
Normal Subjects ◽  
Vessel Density ◽  
Spectral Domain ◽  
Control Group ◽  
Mean Deviation ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Spectral Domain Oct

Purpose. To detect changes in optic nerve head (ONH) vascularization in glaucoma patients using spectral-domain OCT angiography (OCT-A).Material and Method. Fifty glaucoma patients and 30 normal subjects were evaluated with OCT-A (AngioVue®, Optovue). The total ONH vessel density and temporal disc vessel density were measured. Clinical data, visual field (VF) parameters, and spectral-domain OCT evaluation (RNFL: retinal nerve fiber layer thickness, GCC: ganglion cell complex thickness, and rim area) were recorded for glaucoma patients. Correlations among total and temporal ONH vessel density and structural and VF parameters were analyzed.Results. In the glaucoma group, total and temporal ONH vessel density were reduced by 24.7% (0.412 versus 0.547;p<0.0001) and 22.88% (0.364 versus 0.472;p=0.001), respectively, as compared with the control group. Univariate analysis showed significant correlation between rim area (mm2) and temporal ONH vessel density (r=0.623;p<0.0001) and total ONH vessel density (r=0.609;p<0.0001). Significant correlations were found between temporal and total ONH vessel density and RNFL, GCC, VF mean deviation, and visual field index.Conclusion. In glaucoma patients OCT-A might detect reduced ONH blood vessel density that is associated with structural and functional glaucomatous damage. OCT-A might become a useful tool for the evaluation of ONH microcirculation changes in glaucoma.

scholarly journals Estimating Rates of Progression and Predicting Future Visual Fields in Glaucoma Using a Deep Variational Autoencoder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Samuel I. Berchuck ◽  
Sayan Mukherjee ◽  
Felipe A. Medeiros
Keyword(s):  
Visual Field ◽  
Learning Algorithm ◽  
Visual Fields ◽  
Visual Field Loss ◽  
Absolute Error ◽  
Rate Of Change ◽  
Mean Deviation ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Deep Learning Algorithm

AbstractIn this manuscript we develop a deep learning algorithm to improve estimation of rates of progression and prediction of future patterns of visual field loss in glaucoma. A generalized variational auto-encoder (VAE) was trained to learn a low-dimensional representation of standard automated perimetry (SAP) visual fields using 29,161 fields from 3,832 patients. The VAE was trained on a 90% sample of the data, with randomization at the patient level. Using the remaining 10%, rates of progression and predictions were generated, with comparisons to SAP mean deviation (MD) rates and point-wise (PW) regression predictions, respectively. The longitudinal rate of change through the VAE latent space (e.g., with eight dimensions) detected a significantly higher proportion of progression than MD at two (25% vs. 9%) and four (35% vs 15%) years from baseline. Early on, VAE improved prediction over PW, with significantly smaller mean absolute error in predicting the 4th, 6th and 8th visits from the first three (e.g., visit eight: VAE8: 5.14 dB vs. PW: 8.07 dB; P < 0.001). A deep VAE can be used for assessing both rates and trajectories of progression in glaucoma, with the additional benefit of being a generative technique capable of predicting future patterns of visual field damage.

scholarly journals Impact of Visual Field Testing on Intraocular Pressure Change Trends in Healthy People and Glaucoma Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Mengwei Li ◽  
Bingxin Zheng ◽  
Qi Wang ◽  
Xinghuai Sun
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Repeated Measures ◽  
Healthy Subjects ◽  
Open Angle Glaucoma ◽  
Field Testing ◽  
Automated Perimetry ◽  
Open Angle ◽  
Standard Automated Perimetry ◽  
The Impact

Purpose. To compare the impact of visual field (VF) testing on intraocular pressure (IOP) change trends between healthy subjects and glaucoma patients. Methods. We recruited healthy volunteer subjects who did not have previous ocular diseases and open-angle glaucoma patients who were medically controlled well. IOP in both eyes of each participant was measured by using a noncontact tonometer at five time points: before, immediately after (0 minute), and 10, 30, and 60 minutes after the standard automated perimetry. Repeated measures ANOVA was used to analyze the effect of VF testing on IOP change trends in healthy and glaucoma eyes. Results. Forty healthy subjects (80 eyes) and 31 open-angle glaucoma patients (62 eyes) were included for the study. The baseline IOP of healthy and glaucoma eyes was 16.11 ± 3.01 mmHg and 15.78 ± 3.57 mmHg, respectively. After the VF testing, the IOP in healthy eyes was decreased by 1.5% at 0 minute, 6.5% at 10 minutes (P<0.001), 6.6% at 30 minutes (P<0.001), and 7.0% at 1 hour (P<0.001), indicating that this reduction was sustained for at least 1 hour. However, the IOP in glaucoma eyes was increased by 12.7% at 0 minute (P<0.001) and, then, returned towards initial values 1 hour after the VF testing. Conclusions. IOP change trends after VF field testing between healthy subjects and glaucoma patients were quite different. VF testing led to a mild and relatively sustained IOP decrease in healthy subjects, whereas IOP in open-angle glaucoma patients tended to significantly increase immediately after VF testing and, then, returned to pretest values after 1 hour. These findings indicate that the factors of VF testing should be considered in the clinical IOP measurements.

Compass fundus automated perimetry

2018 ◽  
Vol 28 (5) ◽  
pp. 481-490 ◽  
Author(s):  
Paolo Fogagnolo ◽  
Maurizio Digiuni ◽  
Giovanni Montesano ◽  
Chiara Rui ◽  
Marco Morales ◽  
...  
Keyword(s):  
Visual Field ◽  
Visual Fields ◽  
Field Testing ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Gaze Tracking ◽  
Intrinsic Factors ◽  
Global Indices ◽  
Humphrey Field Analyzer ◽  
The Impact

Background: Compass (CenterVue, Padova, Italy) is a fundus automated perimeter which has been introduced in the clinical practice for glaucoma management in 2014. The aim of the article is to review Compass literature, comparing its performances against Humphrey Field Analyzer (Zeiss Humphrey Systems, Dublin, CA, USA). Results: Analyses on both normal and glaucoma subjects agree on the fact that Humphrey Field Analyzer and Compass are interchangeable, as the difference of their global indices is largely inferior than test -retest variability for Humphrey Field Analyzer. Compass also enables interesting opportunities for the assessment of morphology, and the integration between morphology and function on the same device. Conclusion: Visual field testing by standard automated perimetry is limited by a series of intrinsic factors related to the psychophysical nature of the examination; recent papers suggest that gaze tracking is closely related to visual field reliability. Compass, thanks to a retinal tracker and to the active dislocation of stimuli to compensate for eye movements, is able to provide visual fields unaffected by fixation instability. Also, the instrument is a true colour, confocal retinoscope and obtains high-quality 60° × 60° photos of the central retina and stereo-photos details of the optic nerve. Overlapping the image of the retina to field sensitivity may be useful in ascertaining the impact of comorbidities. In addition, the recent introduction of stereoscopic photography may be very useful for better clinical examination.

Comparison of vascular–function and structure–function correlations in glaucomatous eyes with high myopia

2019 ◽  
Vol 104 (6) ◽  
pp. 807-812
Author(s):  
Seung Hyen Lee ◽  
Eun Ji Lee ◽  
Tae-Woo Kim
Keyword(s):  
Visual Field ◽  
Vascular Function ◽  
High Myopia ◽  
Open Angle Glaucoma ◽  
Retinal Vessel ◽  
Retinal Nerve Fibre Layer ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Cross Sectional ◽  
Visual Field Damage

Background/aimsTo determine the usefulness of peripapillary retinal vessel density (VD) measured using optical coherence tomography (OCT) angiography (OCTA) in the evaluation of glaucomatous visual field damage in highly myopic eyes with primary open-angle glaucoma (POAG).MethodsThis cross-sectional observational study enrolled a total of 124 myopic POAG eyes consisting of 40 eyes showing a segmentation error (SE) in OCT scans and 84 eyes without an SE. The peripapillary retinal VD, circumpapillary retinal nerve fibre layer thickness (RNFLT) and visual field sensitivity loss (VFSL) were assessed using OCTA, spectral-domain OCT and standard automated perimetry, respectively. The topographical correlations between the VD and VFSL, and between the RNFLT and VFSL were determined in subgroups divided according to the presence of an SE.ResultsThe peripapillary retinal VD showed significant topographical correlation with VFSL both in the highly myopic POAG eyes without an SE globally (R=0.527, p<0.001), and in temporal (R=0.593), temporal-superior (R=0.543), nasal-inferior (R=0.422) and temporal-inferior sectors (R=0.600, all p<0.001), and in those with an SE globally (R=0.343, p=0.030), and in temporal (R=0.494, p=0.001), temporal-superior (R=0.598, p<0.001), and temporal-inferior sectors (R=0.424, p=0.006). The correlation with VFSL did not differ between the VD and RNFLT in the eyes without an SEConclusionPeripapillary VD as measured with OCTA showed a topographical correlation with VFSL in highly myopic POAG eyes regardless of the presence of an OCT SE OCTA may be a useful adjunct for evaluating glaucomatous visual field damage in high myopia, where the OCT results are frequently confounding.

Detecting Visual Field Progression in Glaucoma – Using the Right Tools for the Job

2013 ◽  
Vol 07 (01) ◽  
pp. 20 ◽  
Author(s):  
Luke J Saunders ◽  
Richard A Russell ◽  
David P Crabb ◽  
◽  
◽  
...  
Keyword(s):  
Visual Field ◽  
Visual Fields ◽  
Field Measurements ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Visual Disability ◽  
New Research ◽  
The Right ◽  
Over Time

Monitoring disease progression is at the centre of managing a patient with glaucoma. This article focuses specifically on how visual field measurements from standard automated perimetry (SAP) can be monitored over time. Various options for analysis on the Humphrey and Octopus perimeters are discussed, from summary indices to event and trend-based analyses; their respective merits and flaws evaluated. It is strongly recommended that quantitative analysis methods and software are used in assessing progression, as variability in threshold measurements makes detecting true deterioration non-trivial. Recommendations on the frequency of visual fields that should be taken per year are also discussed. The article concludes by putting the spotlight on new research being undertaken to improve the methods of measuring and predicting progression, as well as relating visual fields to patient visual disability and quality of life.

Agreement between the newly developed OCT glaucoma staging system and the standardized visual field glaucoma staging system 2

2021 ◽  
pp. 112067212110143
Author(s):  
Elshimaa A Mateen Mossa ◽  
Heba Khallaf ◽  
Khulood Muhammad Sayed
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Staging System ◽  
Control Group ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Cross Sectional ◽  
Stage 4 ◽  
Staging Systems ◽  
Stage 1

Purpose: The purpose of this research was to assess the agreement between the new optical coherence tomography (OCT) glaucoma staging system (GSS) and the visual field (VF) GSS 2 (GSS2). Methods: This is a cross-sectional study of 161 eyes of 110 patients with controlled primary open-angle glaucoma (POAG). All eyes were subjected to VF examination using standard automated perimetry and Humphrey field analyzer II 750. GSS2 was used for the classification of the VF defects’ severity. OCT of the optic disc and the macular ganglion cell complex (GCC) was performed using RTVue. Patients were classified by OCT GSS into six stages. Results: The study examined 161 eyes of 110 patients with controlled POAG. The staging according to VF GSS2 was as follows: stage 0 (12.42%), border stage (12.42%), stage 1 (13.04%), stage 2 (14.29%), stage 3 (14.28%), stage 4 (14.28%), and stage 5 (19.25%). The staging by OCT GSS was as follows: stage 0 (18.6 %), border stage (17.3%), stage 1 (6.8%), stage 2 (9.31%), stage 3 (6%), stage 4 (11.8%), and stage 5 (30.43%). The sensitivity of the new OCT GSS was different in different stages of glaucoma. In this study, no normal control group was considered; thus, the specificity could not be calculated. There was moderate agreement between the two staging systems. Conclusions: OCT GSS is a reliable and objective method for diagnosing and monitoring glaucoma. Correlations were found between GSS2, inferior and total macular GCC thickness values, and cup-to-disc ratios, so considering these items as additional parameters may make this new classification even more sensitive than VF GSS2.

scholarly journals The Assessment of Morphological and Functional Changes in the Detection of the Initial Stage of Primary Glaucoma

2021 ◽  
Vol 18 (4) ◽  
pp. 857-865
Author(s):  
N. I. Kurysheva ◽  
L. V. Lepeshkina
Keyword(s):  
Open Angle Glaucoma ◽  
Angle Closure ◽  
Ganglion Cell Complex ◽  
Automated Perimetry ◽  
Standard Automated Perimetry ◽  
Fiber Layer ◽  
Glaucoma Progression ◽  
Functional Changes ◽  
Primary Glaucoma ◽  
Sd Oct

Purpose — to study morphological and functional changes in the detection of primary glaucoma progression.Patients and methods. 128 patients (128 eyes, among them — 64 eyes with primary open angle glaucoma (POAG) and 64 with primary angle closure glaucoma (PACG)) with the initial MD of –6.0 dB were examined at the Ophthalmology Center of the FMBA of Russia from May 2016 to November 2019. The values of corneal-compensated IOP were also considered: minimal (IOPmin), peak (IOPmax) and its fluctuations (IOPfluct). The progression was measured using standard automated perimetry (SAP) and spectral-domain OCT (SD-OCT). During the observation period, each patient received the average of 8.42 ± 2.08 SAP and SD-OCT. Progressive thinning of the retinal nerve fiber layer (RNFL) and its ganglion cell complex (GCC) were evaluated using SD-OCT. If RNFL and/or GCC had a trend of significant (p < 0.05) thinning, the eye was classified as having the SD-OCT progression. The correlation between the rate of progression detected by SAP (ROP1) using thinning of RNFL (ROP2) and GCC (ROP3) with other clinical parameters was analyzed.Results and discussion. Glaucoma progression was detected in 73 eyes. While the isolated use of SAP did not allow detecting progression, it was possible to detect it in 39 % cases by SD-OCT. The combination of both methods allowed detecting progression in 57 %. In both forms, ROP1 correlated with IOPmin: in PACG r = 0.41, p = 0.023 and in POAG r = 0.43, p = 0.016. In PACG, ROP2 and ROP3 correlated with the foveal choroid thickness: r = 0.46, p = 0.019 and r = 0.47, p = 0.009, respectively. At the same time, ROP3 was associated with peak IOP (r = –0.402, p = 0.025); the correlation of peak IOP with its fluctuations amounted to 0.7 (p < 0.001).Conclusion. SD-OCT is more informative than SAP in determining the progression of the initial primary glaucoma. The combination of these two methods 1.5 times increases the possibility of detecting progression in comparison with the isolated use of SD-OCT. The choroid thickness, associated with the IOP fluctuations, plays an important role in the progression of PACG.

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