Comparison of Event-Based Methods Using Optical Coherence Tomography and Automated Perimetry to Detect the Progression of Glaucoma in Patients with Open-Angle Glaucoma

BACKGROUND/AIMS:To compare event-based methods for estimating the incidence of glaucoma progression using optical coherence tomography (OCT) and automated perimetry and to assess agreement between structural and functional tests for detecting glaucoma progression.METHODS:Functional progression of glaucoma was estimated by guided progression analysis (GPA) using a Humphrey field analyzer (HFA), and structural progression was assessed by OCT and defined as the decrease in retinal nerve fiber layer thickness based on test-retest variability data of previous reports on clock-hour and quadrant maps. The level of agreement between structural and functional progression was evaluated using kappa statistics.RESULTS:Fifty eyes of 50 patients with open-angle glaucoma were enrolled in this retrospective study. The incidence of visual field progression estimated by GPA was 18%. The occurrence of structural progression assessed by OCT ranged from 18 to 68%. The more stringent OCT progression criterion using a quadrant map showed the best agreement with HFA GPA (ĸ = 0.423) and detected perimetric progression with high specificity, while the less stringent OCT criterion considering any clock hour showed the lowest agreement with functional progression (ĸ = 0.098).CONCLUSION:OCT progression criteria based on test-retest variability showed moderate agreement with perimetric progression, and more stringent criteria showed better agreement with functional progression than less stringent ones.