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Updated: Jun 4, 2025
07:11
Assessing Early Stage Open-Angle Glaucoma in Patients by Isolated-Check Visual Evoked Potential
Published on: May 25, 2020
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Risk Factors for Diagnostic Change from Glaucoma Suspect to Primary Open-Angle Glaucoma and Vice Versa Over 2 Years
Lillian K To1, Nicole V Carrabba2, Chaitanya G Kalathuru2
1Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Ophthalmology. Glaucoma
|December 22, 2024
Summary
Diagnostic changes between glaucoma suspect and glaucoma occur in 13.8% of patients. Specialist type and adherence to recommended testing impact these changes, preventing undertreatment and overtreatment.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Diagnostic Accuracy
Background:
- Understanding diagnostic shifts between primary open-angle glaucoma suspect (POAGS) and primary open-angle glaucoma (POAG) is crucial for appropriate patient management.
- This study aimed to identify factors influencing these diagnostic changes in clinical practice.
Purpose of the Study:
- To investigate the incidence and causes of diagnostic changes between POAGS and POAG.
- To identify risk and protective factors associated with these diagnostic shifts.
Main Methods:
- Retrospective, single-site, case-control study including patients over 40 diagnosed with POAG or POAGS between 2013-2020.
- Analysis of baseline characteristics, provider type, and ophthalmic testing (pachymetry, visual fields, OCT, gonioscopy) at initial and follow-up visits.
- Comparison of cases with diagnostic changes to controls without changes over a minimum 24-month follow-up.
Main Results:
- The incidence of diagnostic changes was 13.8%, with most patients upstaged from POAGS to POAG (78%).
- Pre-existing non-glaucomatous visual field defects and less frequent specialist care at initial visits were associated with diagnostic changes.
- Performing visual fields (VFs) or OCT at both visits reduced diagnostic change odds, while changing from a non-specialist to a glaucoma specialist increased these odds.
Conclusions:
- Specialist type and adherence to American Academy of Ophthalmology-recommended testing are key factors in preventing short-term diagnostic changes.
- Understanding these factors can help prevent undertreatment of glaucoma and overtreatment of glaucoma suspects.
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