Imaging progression
Imaging is increasingly valuable in detecting progression
Dermot McGrath
Published: Thursday, February 1, 2018
Imaging is expected to provide information that is relevant for glaucoma management“Nevertheless, regulatory authorities, such as the US FDA, for validation of structural endpoints, request such a strong correlation (R2 of 0.9) to current vision or future vision loss that structural endpoints would never be validated if these criteria will be not revised,” said Dr Oddone. The challenge for the physician, however, is knowing how much of a structural change is clinically significant or what change in vision would be expected to occur, and when, as a result of this structural change, said Dr Oddone. Some recent studies have sought to shed some light on a few of these questions with some measure of success, he said. Zhang et al., for instance, took VF measurements and OCT scans in 417 glaucoma suspect/pre-perimetric glaucoma eyes and 377 perimetric glaucoma eyes every six months for several years. “They showed that baseline reductions in NFL and ganglion cell complex (GCC) thickness can predict the development of VF loss in glaucoma suspects and pre-perimetric glaucoma. Eyes with a borderline or abnormal OCT finding had a five-time greater chance of conversion. Focal GCC and RNFL loss were also found to be the strongest predictors for VF progression in perimetric glaucoma,” he said. Francesco Oddone: oddonef@gmail.com
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