Optic nerve head changes help predict early glaucoma progression

FORT LAUDERDALE, Fla. — Topographic change analysis effectively predicted optic disc and visual field deterioration in patients with clinically stable glaucoma and ocular hypertension, a study showed.

Dimitrios Kourkoutas, MD, and colleagues reported results in a poster at the Association for Research in Vision and Ophthalmology meeting here.

The authors used the Heidelberg Retina Tomograph Topographic Change Analysis (HRT TCA, Heidelberg Engineering) to gauge how well optic nerve head changes predicted optic nerve and/or visual field deterioration.

"Frequency of [visual field] and/or optic nerve head progression was similar between TCA-progressed and TCA-stable patients," the authors said. "Optic nerve head change was associated with an earlier clinical glaucoma progression."

The retrospective study included 78 eyes of 78 patients. Eyes were classified as TCA-progressed or TCA-stable. Two masked specialists determined optic nerve head change based on imaging results.

The median total follow-up interval was 6.9 years, comprising a median retrospective follow-up period of 4.2 years and median prospective follow-up of 2.7 years.

Study results showed that stereo photographic optic nerve head and/or visual field progression occurred in three of 19 TCA-stable patients and eight of 59 TCA-progressed patients.

The mean interval to visual field and/or optic nerve head progression was 26.4 months in TCA-progressed patients and 57.7 months in TCA-stable patients; the difference was statistically significant (P = .008).

TCA-progressed patients were 1.93 times more likely to have stereo photographic optic nerve head changes, the authors said.

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