The Application Of Glaucoma Visual Field And OCT Glucoma Staging System In Detecting Glaucoma Progression Analysis

Objective:To evaluate the progression of primary open angle glaucoma by glaucoma visual field and OCT staging system.The results were compared with traditional VFI linear regression analysis for sensitivity,specificity,and the consistency of each other.The effectiveness and clinical value of the two classification systems in the analysis of glaucoma progress were evaluated.Method:Observational cohort study.A total of 76 eyes of 38 patients with primary open angle glaucoma were enrolled.All patients received at least 5 reliable standard automatic perimeter(SAP)tests and at least 5 optical coherence tomography(OCT)measurements.There was a 2-year separation between the first and last measurents.Based on the parameters such as the VFI,MD,PSD,Superior RNFL thickness,Inferior RNFL thickness and age of patients.The stage and defect types of Enhanced Glaucoma staging system and OCT staging system can be dedived.By linear regression analysis,the stages of each eye follow up in GSS 2 and OCT GSS were changed with time.If the slope of the regression equation was positive and the regression coefficient was significant(P<0.05),the progression was considered.Compare the progression of the GSS 2,OCT GSS and visual field index(VFI),and evaluate the value of GSS 2 and OCT GSS for the analysis of the progress of glaucoma.Results:The mean value of MD in the group of patients was-5.23±5.87dB,the mean baseline PSD was 5.28±4.19dB,the Superior RNFL average thickness of the baseline was 96.01±25.02?m,and the Inferior RNFL average thickness of the baseline was 100.51 ± 32.62?m.In these 76 eyes,2 eyes(2.6%)detected progression by three methods.The detection rate using one method is 23 cases(30.26%)for VFI,14 cases(18.42%)for GSS 2,and 21 cases(27.63%)for OCT GSS.The detection rate of VFI combined with GSS 2 was 13 cases(17.1%).The detection rate of VFI combined with OCT GSS was 8 cases(10.53%),and the detection rate of GSS 2 combined OCT GSS was 7 cases(9.2%).Of the three methods,25 eyes(32.89%)had no progression.However,the progression of VFI was 53(69.74%),GSS 2 was 62(81.58%),and OCT GSS was 55(72.38%).The detection rate of VFI combined with GSS 2 was 52 cases(68.42%).The detection rate of VFI combined with OCT GSS was 41 cases(53.95%),and the detection rate of GSS 2 combined OCT GSS was 55 cases(72.37%).Conclusion:The sensitivity of GSS 2 to detect the progression of glaucoma was 56.52%,the specificity was 96.23%,and the sensitivity of the OCT GSS for the detect the progression of glaucoma was 34.78%and the specificity was 73.58%.Using GSS 2 and OCT GSS is a new and clinically useful tool for the analysis of glaucoma progression.