Department of Psychology, Columbia University, New York, New York; Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Columbia University Irving Medical Center, New York, New York.
Department of Psychology, Columbia University, New York, New York.
Ophthalmol Glaucoma. 2022 Nov-Dec;5(6):614-627. doi: 10.1016/j.ogla.2022.03.007. Epub 2022 Mar 28.
To better understand the efficacy of the 24-2 guided progression analysis (GPA) in the detection of progression in eyes with early glaucoma (i.e., 24-2 mean deviation [MD] better than -6 dB) by comparing 24-2 GPA with a reference standard (RS) based on a combination of OCT and 24-2 and 10-2 visual field (VF) information.
Cross-sectional study.
Ninety-nine eyes from 99 individuals, including 70 suspected or early glaucomatous eyes (24-2 MD better than -6 dB) and 29 healthy controls (HCs).
All the eyes had at least 4 OCT and VF test dates over a period that ranged from 12 to 59 months. The 24-2 VF tests included 2 baseline tests and at least 2 follow-up tests. The 2 baseline tests were performed within an average of 5.6 days (median, 7 days), and the last follow-up test was performed at least 1 year after the first baseline visit.
A commercial 24-2 GPA software, with default settings, characterized the eyes as having "likely progression" (LP) or "possible progression" (PP); both were considered "progressing" for this analysis. For RS, 3 authors graded progression using strict criteria and a combination of a custom OCT progression report and commercial 24-2 and 10-2 GPA reports for the same test dates as GPA.
The reference standard identified 10 (14%) of the 70 patient eyes and none of the HC eyes as having progression. The 24-2 guided progression analysis identified 13 of the 70 patient eyes as having progression (PP or LP). However, it correctly classified only 4 (40%) of the 10 RS progressors. All 6 of the RS progressors missed by the 24-2 GPA showed progression in the macula. In addition, the 24-2 GPA identified 2 of the 29 HC eyes as progressors and 9 patient eyes without progression based on the RS.
In eyes with early glaucoma (i.e., 24-2 MD, > -6 dB) in this study, the 24-2 GPA missed progression seen using OCT and exhibited a relatively high rate of false positives. Furthermore, the region progressing typically included the macula. The results suggest that including OCT and/or 10-2 VFs should improve the detection of progression.
通过将 24-2 引导的进展分析（GPA）与基于 OCT 和 24-2 及 10-2 视野（VF）信息组合的参考标准（RS）进行比较，更好地了解 24-2 GPA 在检测早期青光眼（即 24-2 平均偏差[MD]优于-6 dB）眼中进展的功效。
横断面研究。
99 名个体的 99 只眼，包括 70 只疑似或早期青光眼眼（24-2 MD 优于-6 dB）和 29 只健康对照（HC）。
所有眼睛均至少有 4 次 OCT 和 VF 测试日期，时间范围从 12 到 59 个月。24-2 VF 测试包括 2 次基线测试和至少 2 次随访测试。2 次基线测试在平均 5.6 天（中位数 7 天）内进行，最后一次随访测试在首次基线就诊后至少 1 年进行。
商业 24-2 GPA 软件（默认设置）将眼睛标记为“可能进展”（LP）或“可能进展”（PP）；这两种情况都被认为是“进展”。对于 RS，3 位作者使用严格的标准和定制的 OCT 进展报告以及相同测试日期的商业 24-2 和 10-2 GPA 报告来评估进展情况。
参考标准确定了 70 例患者眼中的 10 只（14%）和 HC 眼中的 0 只眼有进展。24-2 引导的进展分析确定了 70 例患者眼中的 13 只（PP 或 LP）有进展。然而，它仅正确分类了 RS 进展者中的 4 只（40%）。24-2 GPA 错过的所有 6 例 RS 进展者在黄斑区均显示出进展。此外，24-2 GPA 将 2 只 29 只 HC 眼中的进展者和 9 只基于 RS 无进展的患者眼中的进展者识别出来。
在本研究中，患有早期青光眼（即 24-2 MD，>-6 dB）的眼中，24-2 GPA 错过了使用 OCT 观察到的进展，并且表现出相对较高的假阳性率。此外，进展的典型区域包括黄斑区。结果表明，包括 OCT 和/或 10-2 VFs 应该可以提高进展的检测能力。
