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.
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).
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.
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: email@example.com).
Received for publication March 31, 2008; accepted July 20, 2008
Proprietary Interest: None.