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Comparison of Mean Deviation With AGIS and CIGTS Scores in Association With Structural Parameters in Glaucomatous Eyes

Naka, Maiko MD; Kanamori, Akiyasu MD, PhD; Tatsumi, Yasuko MD, PhD; Fujioka, Miyuki MD, PhD; Nagai-Kusuhara, Azusa MD, PhD; Nakamura, Makoto MD, PhD; Negi, Akira MD, PhD

doi: 10.1097/IJG.0b013e3181879e75
Original Studies

Objective To evaluate which of the 3 clinically used visual field indices including mean deviation (MD), Advanced Glaucoma Intervention Study (AGIS) score, and Collaborative Initial Glaucoma Treatment Study (CIGTS) score are best in evaluating functional damage of glaucomatous optic neuropathy.

Methods In 213 glaucomatous eyes, peripapillary retinal nerve fiber layer thickness (RNFLT) and optic disc configuration were measured with Stratus optical coherence tomography and Heidelberg Retina Tomograph-2, respectively. Visual field was measured with standard automated perimetry 30-2. Correlations of the structural parameters compared with the 3 VF indices using second polynomial regression were calculated. In addition, these correlations were analyzed among eyes of 3 different stages of glaucoma, as defined by MD score (early, MD≥−6 dB; moderate, −12 dB≤MD<−6 dB; advanced, MD<−12 dB).

Results Among structure-function relationships in all subjects, the highest correlation determination (R2) was MD with RNFLT (=0.298). CIGTS score showed better R2 than MD or AGIS score with rim area, but these values were not higher than any R2 with RNFLT. In analyses of 3 groups depending on MD, statistically significant structure-function correlations were observed only in patients with an advanced stage.

Conclusions No clear difference was found among MD and AGIS/CIGTS scores in expressing functional damage of glaucomatous eyes. MD is suggested to be no worse than others in monitoring glaucoma in clinical setting.

Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Chuo-ku, Kobe, Japan

Supported by the Ministry of Education, Culture, Sports, Science and Technology of the Japanese Government; Grant-in-Aid No. 19791267 (A.K.), No. 17591835 (M.N.), and No. 19390444 (A.N., M.N., A.K.) and Imai Memorial Foundation for Glaucoma Research (A.K.).

Reprints: Akiyasu Kanamori, MD, PhD, Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan (e-mail:

Received for publication March 31, 2008; accepted July 20, 2008

Proprietary Interest: None.

© 2009 Lippincott Williams & Wilkins, Inc.