Visual field index rate and event-based glaucoma progression analysis: comparison in a glaucoma population.

Area of Science:

• Ophthalmology
• Medical Technology
• Data Analysis

Background:

• Glaucoma management relies on detecting progressive visual field loss.
• Current methods include event-based Glaucoma Progression Analysis (GPA) and trend-based Visual Field Index (VFI).

Purpose of the Study:

• To compare the efficacy of event-based GPA (versions I and II) against pattern deviation-based trend analysis (VFI) in detecting glaucoma progression.
• To assess the agreement between different glaucoma progression analysis methods.

Main Methods:

• Retrospective study of 90 eyes from 90 glaucoma patients.
• Minimum of five reliable visual field tests and 2-year follow-up.
• Comparison of GPA I, GPA II, VFI, and Mean Deviation (MD) linear analysis.

Main Results:

• GPA II detected progression in 16.7% of cases missed by VFI.
• GPA identified progression 6.8 months earlier than VFI.
• Excellent agreement between GPA I and II (k=0.94); moderate agreement between VFI and MD (k=0.52) or GPA (k=0.48).

Conclusions:

• Event-based GPA software (I and II) demonstrates excellent agreement and superior sensitivity for earlier glaucoma progression detection compared to VFI.
• VFI requires longer follow-up and more tests for progression detection and shows only moderate agreement with other methods.
• VFI analysis is more accurate than MD analysis for determining the rate of progression.