No abstract

Purpose To evaluate a progression-detecting algorithm for a new automated matched alternation flicker (AMAF) in glaucoma patients. Methods Open-angle glaucoma patients with a baseline mean deviation of visual field (VF) test4 − 6 dB were included in this longitudinal and retrospective study. Functional progression was detected by two VF progression criteria and structural progression by both AMAF and conventional comparison methods using optic disc and retinal nerve fiber layer (RNFL) photography. Progression-detecting performances of AMAF and the conventional method were evaluated by an agreement between functional and structural progression criteria. RNFL thickness changes measured by optical coherence tomography (OCT) were compared between progressing and stable eyes determined by each method. Results Among 103 eyes, 47 (45.6%), 21 (20.4%), and 32 (31.1%) eyes were evaluated as glaucoma progression using AMAF, the conventional method, and guided progression analysis (GPA) of the VF test, respectively. The AMAF showed better agreement than the conventional method, using GPA of the VF test (κ = 0.337; Po0.001 and κ = 0.124; P = 0.191, respectively). The rates of RNFL thickness decay using OCT were significantly different between the progressing and stable eyes when progression was determined by AMAF (−3.49 ± 2.86 μm per year vs − 1.83 ± 3.22 μm per year; P = 0.007) but not by the conventional method (−3.24 ± 2.42 μm per year vs − 2.42 ± 3.33 μm per year; P = 0.290). Conclusions The AMAF was better than the conventional comparison method in discriminating structural changes during glaucoma progression, and showed a moderate agreement with functional progression criteria.