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The collaborative initial glaucoma treatment study: baseline visual field and test-retest variability.

Brenda W Gillespie1, David C Musch, Kenneth E Guire

  • 1Department of Biostatistics, Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA. bgillesp@umich.edu

Investigative Ophthalmology & Visual Science
|May 27, 2003
PubMed
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The Collaborative Initial Glaucoma Treatment Study (CIGTS) visual field (VF) score closely mirrors mean deviation (MD), with specific patient factors predicting VF loss and variability. This aids in identifying glaucoma patients needing closer monitoring.

Area of Science:

  • Ophthalmology
  • Clinical Research
  • Glaucoma Studies

Background:

  • Open-angle glaucoma diagnosis requires accurate visual field (VF) assessment.
  • The Collaborative Initial Glaucoma Treatment Study (CIGTS) introduced a novel VF scoring system.
  • Understanding baseline VF characteristics and variability is crucial for patient management.

Purpose of the Study:

  • Compare the CIGTS visual field (VF) score with mean deviation (MD).
  • Investigate the test-retest variability of these measures.
  • Identify factors associated with VF loss and measurement variability in newly diagnosed open-angle glaucoma patients.

Main Methods:

  • Utilized baseline data from 607 patients in a randomized clinical trial for newly diagnosed open-angle glaucoma.

Related Experiment Videos

  • Collected CIGTS VF scores and MD from 24-2 VF tests at two visits approximately two weeks apart.
  • Analyzed correlations and identified predictors for VF loss and variability.

    • Main Results:

    • Most patients had limited baseline VF loss, but 15% exhibited substantial deficits.
    • A small learning effect was observed for both CIGTS VF score and MD.
    • CIGTS VF score and MD showed high correlation (r = -0.93) and test-retest reliability (0.83 and 0.91, respectively).
    • Factors like male sex, black race, lower visual acuity, higher intraocular pressure, poor reliability, cardiovascular disease, reduced alertness, and clinical center predicted VF loss.
    • Midrange VF score, first-tested eye, reduced alertness, increasing age, smoking, and clinical center predicted increased CIGTS VF score variability.

    Conclusions:

    • The CIGTS VF score is a reliable measure comparable to MD.
    • Identifying variables associated with VF loss and variability can help pinpoint glaucoma patients requiring enhanced clinical attention.