Structural and Functional Progression in the Early Manifest Glaucoma Trial.

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Structural and Functional Progression in the Early Manifest Glaucoma Trial. / Öhnell, HannaMaria; Heijl, Anders; Brenner, Lena; Anderson, Harald; Bengtsson, Boel.

In: Ophthalmology, Vol. 123, No. 6, 2016, p. 1173-1180.

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TY - JOUR

T1 - Structural and Functional Progression in the Early Manifest Glaucoma Trial.

AU - Öhnell, HannaMaria

AU - Heijl, Anders

AU - Brenner, Lena

AU - Anderson, Harald

AU - Bengtsson, Boel

PY - 2016

Y1 - 2016

N2 - PurposeTo elucidate the temporal relationship between detection of glaucomatous optic disc progression, as assessed by fundus photography, and visual field progression.DesignProspective, randomized, longitudinal trial.ParticipantsThree hundred six study eyes with manifest glaucoma with field loss and 192 fellow eyes without any field defect at the start of the trial, from a total of 249 subjects included in the Early Manifest Glaucoma Trial (EMGT), were assessed.MethodsEvaluation of visual field progression and optic disc progression during an 8-year follow-up period. Three graders independently assessed optic disc progression in optic disc photographs. Visual field progression was assessed using glaucoma change probability maps and the EMGT progression criterion.Main Outcome MeasuresTime to detection of visual field progression and optic disc progression.ResultsAmong study eyes with manifest glaucoma, progression was detected in the visual field first in 163 eyes (52%) and in the optic disc first in 39 eyes (12%); in 1 eye (0%), it was found simultaneously with both methods. Among fellow eyes with normal fields, progression was detected in the visual field first in 28 eyes (15%) and in the optic disc first in 34 eyes (18%); in 1 eye (1%), it occurred simultaneously.ConclusionsIn eyes with manifest glaucoma, progression in the visual field was detected first more than 4 times as often as progression in the optic disc. Among fellow eyes without visual field loss at baseline, progression was detected first as frequently in the optic disc as in the visual field.

AB - PurposeTo elucidate the temporal relationship between detection of glaucomatous optic disc progression, as assessed by fundus photography, and visual field progression.DesignProspective, randomized, longitudinal trial.ParticipantsThree hundred six study eyes with manifest glaucoma with field loss and 192 fellow eyes without any field defect at the start of the trial, from a total of 249 subjects included in the Early Manifest Glaucoma Trial (EMGT), were assessed.MethodsEvaluation of visual field progression and optic disc progression during an 8-year follow-up period. Three graders independently assessed optic disc progression in optic disc photographs. Visual field progression was assessed using glaucoma change probability maps and the EMGT progression criterion.Main Outcome MeasuresTime to detection of visual field progression and optic disc progression.ResultsAmong study eyes with manifest glaucoma, progression was detected in the visual field first in 163 eyes (52%) and in the optic disc first in 39 eyes (12%); in 1 eye (0%), it was found simultaneously with both methods. Among fellow eyes with normal fields, progression was detected in the visual field first in 28 eyes (15%) and in the optic disc first in 34 eyes (18%); in 1 eye (1%), it occurred simultaneously.ConclusionsIn eyes with manifest glaucoma, progression in the visual field was detected first more than 4 times as often as progression in the optic disc. Among fellow eyes without visual field loss at baseline, progression was detected first as frequently in the optic disc as in the visual field.

U2 - 10.1016/j.ophtha.2016.01.039

DO - 10.1016/j.ophtha.2016.01.039

M3 - Article

VL - 123

SP - 1173

EP - 1180

JO - Ophthalmology

T2 - Ophthalmology

JF - Ophthalmology

SN - 1549-4713

IS - 6

ER -