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Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
Detection of visual-field deterioration by Glaucoma Progression Analysis and Threshold Noiseless Trend programs
V T Diaz-Aleman1, A Anton, M Gonzalez de la Rosa
1The Eye Clinic, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN, UK.
The British Journal of Ophthalmology
|July 16, 2008
Summary
Threshold Noiseless Trend (TNT) better detects visual-field deterioration in glaucoma patients compared to Glaucoma Progression Analysis (GPA). TNT showed higher concordance with expert opinions, indicating its potential for improved glaucoma management.
Area of Science:
- Ophthalmology
- Medical technology
- Glaucoma research
Background:
- Glaucoma is a progressive optic neuropathy.
- Early detection of visual-field deterioration is crucial for managing glaucoma.
- Automated analysis programs aim to aid in detecting disease progression.
Purpose of the Study:
- To compare the efficacy of Glaucoma Progression Analysis (GPA) and Threshold Noiseless Trend (TNT) software in identifying visual-field deterioration.
- To evaluate the concordance of these programs with expert clinical assessment.
Main Methods:
- Retrospective analysis of 56 eyes from 42 open-angle glaucoma patients.
- Minimum 2-year follow-up with at least seven reliable visual fields per patient.
- Progression assessment by four masked glaucoma experts, compared against GPA and TNT outputs.
Main Results:
- Threshold Noiseless Trend (TNT) identified progression in 24 eyes, while Glaucoma Progression Analysis (GPA) detected it in six eyes.
- TNT demonstrated 100% sensitivity and 77% specificity, compared to GPA's 75% sensitivity and 83% specificity, using expert consensus as the gold standard.
- Interobserver agreement among experts for detecting progression was good (mean kappa = 0.57).
Conclusions:
- Threshold Noiseless Trend (TNT) exhibited superior concordance with expert opinions in detecting visual-field deterioration compared to Glaucoma Progression Analysis (GPA).
- Glaucoma Progression Analysis (GPA) showed high specificity but lower sensitivity, primarily identifying cases with significant focality and steep mean defect slopes.
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