Agreement between structural and functional classifications in glaucoma diagnosis

Abstract

Purpose To evaluate the agreement between the Moorfields regression analysis classification (MRA) of the Heidelberg retina Tomograph 3 (HRT3; Heidelberg Engineering, Heidelberg, Germany) and the functional classification of white‐on‐white Heidelberg Edge Perimetry (HEP, Heidelberg Engineering). Methods Fifty‐seven normal subjects and 89 age‐matched glaucoma subjects were selected.Only one eye per subject was randomly included in the statistical analysis. All glaucoma patients had an intraocular pressure higher than 21 mmHg and abnormal Humphrey visual fields. The glaucoma group was divided into three subsets, according to the subject’s level of visual field loss (Hodapp‐Parrish‐Anderson score). All participants underwent a comprehensive ophthalmic examination, at least a reliable Humphrey perimetry, at least a reliable HEP and imaging with the HRT3. The agreement between color‐coded classifications of both, MRA and HEP, was calculated for each sector of the optic nerve head: nasal‐superior Results Mean age was 52.9 ± 9.5 years in the control group and 55.5 ± 9.7 years in the glaucoma group (p=0.104). In the control group, the best agreement was found for NI sector (100%), while the worst agreement was observed for TI sector (93%). Patients with mild glaucoma (n=59) had the best agreement at NS sector (79.7%) while patients with moderate glaucoma (n=18) had the best agreement at NS, TS and TI sectors (88.9%), and patients with severe glaucoma (n=12) had the best agreement at NS, TS, TI and T sectors (83.3%). Conclusion In general, MRA and functional classification of HEP showed moderate to good agreement. The best agreement between both classifications was observed in healthy and patients with mild glaucoma.