Strategies for improving early detection of glaucoma: the combined structure-function index

Area of Science:

• Ophthalmology
• Medical Imaging
• Diagnostic Strategies

Background:

• Early glaucoma detection is vital to prevent irreversible visual field loss.
• Ocular imaging advances aid diagnosis, but combining structural and functional tests is optimal.
• Retinal ganglion cell estimation from OCT and perimetry is feasible.

Purpose of the Study:

• To review novel strategies for enhancing early glaucoma detection.
• To highlight the potential of the combined structure-function index (CSFI).
• To discuss integrating diverse data for improved glaucoma probability estimates.

Main Methods:

• Estimating retinal ganglion cell count using optical coherence tomography (OCT) and standard automated perimetry (SAP).
• Calculating the combined structure-function index (CSFI) as a percentage of cell loss.
• Reviewing studies on CSFI performance in glaucoma detection, including preperimetric stages.

Main Results:

• The CSFI may offer superior glaucoma detection compared to isolated structural or functional measures.
• CSFI demonstrates effectiveness even in early, preperimetric glaucoma.
• Integrating demographic, clinical, and test data can refine disease probability models.

Conclusions:

• The CSFI represents a promising advancement for early glaucoma diagnosis.
• Future strategies involve combining CSFI with other risk factors and data for comprehensive assessment.
• Improved early detection models can significantly mitigate glaucoma's impact.