Comparison of PROGRESSOR and Glaucoma Progression Analysis 2 to Detect Visual Field Progression in Treated Glaucoma...

We compared the abilities of PROGRESSOR and Glaucoma Progression Analysis 2 (GPA2) to detect glaucomatous visual field (VF) progression.

Retrospective cohort.

We reviewed the charts of glaucoma patients with repeatable VF loss and ≥ 8 SITA-Standard 24-2 VFs. Progression was evaluated using 3 methods: (1) PROGRESSOR pointwise linear regression (Medisoft, Inc), (2) GPA2 VF index (VFI) regression (GPA-VFI), and (3) GPA Early Manifest Glaucoma Trial (EMGT) criteria (Carl Zeiss Meditec, Inc; GPA-EMGT). For PROGRESSOR, progression was determined when at least 2 adjacent test points in the same hemifield progressed by more than 1.0 dB/y, P < 0.01. For GPA-VFI, progression was defined when VFI rate was more than 1.0%/y, P < 0.01.

A total of 130 eyes [130 patients; mean (SD) age, 63.6 (12.7) years; mean (SD) number of VF, 11.2 (3.6); mean follow-up time, 7.3 (1.8) years] were enrolled. There was a significant correlation between VFI and PROGRESSOR rates of change (r = 0.81, P < 0.01). The number of eyes progressing based on PROGRESSOR, GPA-VFI, and the GPA-EMGT criteria was 55, 37, and 46, respectively (P = 0.06). There was a moderate agreement between PROGRESSOR and the GPA-EMGT (κ = 0.43), between PROGRESSOR and GPA-VFI (κ = 0.57), and between GPA-VFI and GPA-EMGT (κ = 0.45). PROGRESSOR and GPA-EMGT tended to detect similar numbers of progressing points per eye [3.7 (5.8) vs 3.1 (4.4), P = 0.50, respectively].

The 3 methods showed statistically similar sensitivities for the detection of VF progression. In addition, the EMGT and PROGRESSOR criteria revealed good spatial consistency.