Computer perimetry indices in glaucoma stage assessment

Purpose: To study the role of Octopus computer visual field indices in assessing the stages of the glaucomatous process. Successful treatment of primary open-angle glaucoma (POAG) largely depends on the possibility of reliable control of its effectiveness. The system of POAG early detection and monitoring has significant problems: insufficient clinical coverage of the population, poor quality of patients’ examination at the outpatient level. Standard automated perimetry (SAP) is the golden standard in glaucoma diagnosis and is suitable for a life-long clinical examination of POAG patients. Currently, ophthalmologists do not fully use all the features of this method to determine the stages of POAG.

Methods: The study included 150 patients with POAG (284 eyes). According to the results of the study in 102 patients with POAG (193 eyes), exclusion criteria that affect the reliability of SAP indicators were identified The results were evaluated in 48 patients (91 eyes) with POAG diagnosed at least 2 years prior. This group included 27 women (56.3%) and 21 men (43.7%), the average age of patients was 64±10.2 (σ=0.036). The control group consisted of 26 people (52 eyes) — 16 women (61.5%) and 10 men (38.5%). The average age of these subjects was 61±9.0 years. (σ=0.030). All patients underwent a study of the central visual field on the Octopus-101 perimeter (Switzerland), G2 program (glaucomatous test).

Results: The corrected loss variance index (СLV) of the Octopus computer visual field analyzer is the most important for determining of the stage of glaucoma. The СLV index less than 8 dB is found in patients without glaucoma. The CLV index interval from 8.1 dB to 19.0 dB corresponds to stage I of POAG, from 19.1 dB to 36.0 dB — to stage II of POAG and the CLV index value of more than 36.1 dB corresponds to stage III of POAG.

Conclusion: Glaucoma stage of can be determined not only by the location and depth of the central visual field loss but also based on the evaluation of statistical indicators available in a number of models of automated perimeters. Based on that, we propose a screening method for glaucoma stage assessment in outpatient clinic conditions.

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