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Predicting Progression to Glaucoma in Ocular Hypertensive Patients

Strouthidis, Nicholas G. MD, MRCOphth* †; Gardiner, Stuart K. PhD; Owen, Victoria M.F. MSc; Zuniga, Claudio MD*; Garway-Heath, David F. MD, FRCOphth* ‡

doi: 10.1097/IJG.0b013e3181b6e5a1
Original Studies

Purpose To assess the ability of Heidelberg Retina Tomograph (HRT) Moorfields Regression Analysis (MRA) and Glaucoma Probability Score (GPS) classifications at baseline to predict glaucomatous progression in ocular hypertensive eyes.

Methods One hundred ninety-eight ocular hypertensive subjects underwent regular HRT and visual field (VF) testing from 1993 to 2001. HRT progression was assessed using linear regression of rim area/time. VF progression was assessed by pointwise linear regression of sensitivity/time. Subjects were classified as progressing or stable at the end of the study period. The relationship between baseline abnormal (outside normal limits combined with borderline classification) MRA and GPS classification and progression status was assessed by odds ratios (ORs).

Results An abnormal superotemporal MRA was the only classification found to be predictive of HRT progression in isolation (OR 3.05, 1.25-7.47). Abnormal global, superotemporal, superonasal, and temporal MRA classifications were all associated with significant ORs for predicting HRT or VF progression (OR range: 1.77-2.54). Abnormal GPS classifications were not predictive of disease behavior. Combined abnormal GPS and MRA classifications were associated with higher ORs than either classification in isolation.

Conclusions Patients with an abnormal MRA and GPS classification at presentation may be at increased risk of HRT or VF change.

*Glaucoma Research Unit, NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, UCL Institute of Ophthalmology

Department of Optometry and Visual Science, City University, London, UK

Discoveries in Sight Laboratories, Devers Eye Institute, Legacy Health System, Portland, OR

The corresponding author has received a proportion of his funding from the Department of Health's National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology.

Competing Interests: N.G.S. was funded by a Friends of Moorfields research fellowship and through an unrestricted grant from Heidelberg Engineering.

Reprints: David F. Garway-Heath, MD, FRCOphth, Glaucoma Research Unit, Moorfields Eye Hospital, 162 City Road, London EC1 V 2PD (e-mail:

Received for publication September 30, 2008

accepted July 10, 2009

The views expressed in this publication are those of the authors and not necessarily those of the Department of Health.

© 2010 Lippincott Williams & Wilkins, Inc.