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Detection of morphological and functional progression in initial glaucoma
  1. Manuel Gonzalez de la Rosa1,*,
  2. Marta Gonzalez-Hernandez2,
  3. Manuel Sanchez-Mendez2,
  4. Erika Medina-Mesa2,
  5. Ricardo Rodriguez de la Vega2
  1. 1 Universidad de la Laguna, Spain;
  2. 2 Hospital Universitario de Canarias, Spain
  1. Correspondence to: Manuel A Gonzalez de la Rosa, Ophthalmology, University of La Laguna, 25 de Julio 34 bajo, Santa Cruz de Tenerife, 38004, Spain; mgdelarosa{at}telefonica.net

Abstract

Background: To observe the prospective follow up results of functional and morphological data in patients with early, moderate and suspected glaucoma.

Methods: 156 eyes were examined every three months for an average of 3.6 years. Progression was estimated using regression analysis of the indices Rim Area and Glaucoma Probability Score of the Heidelberg Retinal Tomograph, mean thickness of the fibre layer using laser polarimetry with corneal compensation, mean defects of Standard, Pulsar and Frequency Doubling Technology perimetries, and the Threshold Noiseless Trend program for the Standard and Pulsar perimetries.

Results: Threshold Noiseless Trend (TNT) showed more than twice the diagnostic capacity of other methods. The maximum diagnostic sensitivity was obtained with TNT Pulsar.This procedure indicated progression in 40% of cases after seven examinations, and presented the lowest number of cases of progression not confirmed in two consecutive examinations. Most of the progressions of initial glaucomas were diffuse, without changes in the lens or loss of visual acuity. Heidelberg Retinal Tomograph and laser polarimetry made few diagnoses of progression. The diagnostic agreement between different methods was low, but higher between functional than morphological procedures.

Conclusion: Functional indices, especially Pulsar, showed better detection of progression than morphological indices.

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