Newer imaging tools overtake visual fields, fundus photography in OAG surveillance

Ancillary ocular imaging technologies for evaluating patients with open-angle glaucoma such as confocal scanning laser ophthalmoscopy, scanning laser polarimetry and optical coherence tomography surged in the last decade, while visual field testing and fundus photography declined, according to a large study.

“These procedures can be performed quickly, are painless, are relatively easy to perform on most patients, and require no subjective patient input,” the study authors said. “However, it is unclear how well these devices can detect glaucomatous progression; moreover, they may yield unreliable results in some patients.”

The retrospective, longitudinal cohort analysis included 169,917 patients with open-angle glaucoma (OAG) and 395,721 patients with suspected OAG. Mean age patient age was 55.1 years.

Investigators analyzed trends in visual field testing, fundus photography and other ocular imaging modalities for patients with OAG or suspected OAG between 2001 and 2009.

Study results showed that patients’ odds of undergoing visual field testing diminished by 36% between 2001 and 2005, 12% between 2005 and 2009, and 44% between 2001 and 2009. The odds of undergoing other imaging testing increased by 100% between 2001 and 2005, 24% between 2005 and 2009, and 147% between 2001 and 2009.

The probability of undergoing fundus photography ranged from 13% to 25% for patients under the exclusive care of either optometrists or ophthalmologists.

The probability of undergoing other ocular imaging testing increased from 26% in 2001 to 47% in 2009 for patients under the care of optometrists, and from 30% in 2001 to 46% in 2009 for patients of ophthalmologists.

In 2008, patients cared for exclusively by optometrists had a higher probability of undergoing other imaging testing than visual field testing, the authors said.

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Source:

Ophthalmology. 2012;119(4):748-758.