Structure-Function Agreement Is Better Than Commonly Thought in Eyes With Early Glaucoma

Area of Science:

• Ophthalmology
• Medical Imaging
• Glaucoma Research

Background:

• Glaucoma diagnosis relies on correlating structural damage (optical coherence tomography [OCT]) with functional deficits (visual field [VF]).
• Accurate agreement assessment between OCT and VF is crucial for timely glaucoma management.
• Existing methods may vary in their ability to detect early glaucomatous changes.

Purpose of the Study:

• To evaluate the concordance between structural (OCT) and functional (VF) glaucomatous damage using an automated method.
• To compare the performance of this automated method against a metric-based approach.
• To determine the efficacy of combining 24-2 and 10-2 VF data with OCT for glaucoma assessment.

Main Methods:

• Acquired wide-field spectral-domain OCT scans (disc and macula) and 24-2/10-2 VFs from healthy controls and glaucoma patients.
• Assessed abnormal structure-abnormal function (aS-aF) agreement using an automated topographic (T) method based on VF pattern deviation and OCT probability maps.
• Compared the automated method's results with a metric (M) method utilizing specific VF and OCT criteria.

Main Results:

• The automated topographic method achieved an aS-aF agreement in 88.7% of glaucoma eyes, compared to 4.5% in healthy eyes.
• Excluding 10-2 VF data reduced the automated method's agreement to 64.2% in glaucoma eyes.
• The metric method showed lower agreement (69.8% with 10-2 VF, 62.3% without).

Conclusions:

• Good agreement exists between structural and functional glaucoma damage, even in early stages, when both 24-2 and 10-2 VFs are utilized.
• The automated method provides an objective and effective way to assess structure-function concordance in glaucoma.
• Combining comprehensive VF data (24-2 and 10-2) with OCT scans enhances the accuracy of glaucoma detection.