Disc Damage as a Prognostic and Therapeutic Consideration in the Management of Patients with Glaucoma

Spaeth, George L.; Hwang, Sungsoon; Gomes, M.

doi:10.1007/978-3-642-60203-0_16

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…The systems of disc and field grading used in this study are believed to be more appropriate, since no stereo photography of the optic nerve head was available and, as done in other studies (13,14) we had to consider a categorical manner to analyze different visual field perimeters during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the diversity of the visual field examinations methods over the extended follow-up period, a generic grading system was used to grade all glaucomatous field defects: grade 0 -no visual field defect present; grade I -nasal step or localized paracentral defect; grade II -nasal step and paracentral defect or a single arcuate defect; grade III -two arcuate scotomas or an altitudinal scotoma not encroaching on fixation; grade IV -advanced visual field loss with or without fixation loss (13) . Patients with ocular diseases that might mislead the interpretation of visual field testing were excluded.…”

Section: Methodsmentioning

confidence: 99%

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Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years

Paula¹,

Furtado²,

Santos³

et al. 2012

Arq. Bras. Oftalmol.

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Purpose: To determine the proportion of blindness and investigate the relationships between risk factors based on clinical characteristics and development of blindness in patients with primary open-angle glaucoma (POAG) treated for at least 15 years. Methods: A retrospective observational chart review was performed with 403 pa tients referred to a tertiary level hospital, each with a diagnosis of primary openangle glaucoma, treated for at least 15 years. Blindness attributable to glaucoma was defined based on visual acuity and/or visual field tests. Variables considered to be possible risk factors for blindness were evaluated using odds ratio (OR), confidence interval (95% CI), and univariate and multivariate analyses. Results: Thirty-one patients became blind [13/53 (24.5%) -unilaterally and 18/53 (34%) -bilaterally] during the follow-up period of treatment (19.5 ± 4.6 years, range 15-31 years). Multivariate statistics with regression analysis revealed that persis tency on initial therapy ≤6 months was significantly associated with blindness, both unilateral (OR: 8.4; 95% CI: 1.3-56.4) and bilateral (OR: 7.2; 95% CI: 1.3-39.6). Other potential factors such as race, age, gender or number of medications were not associated with blindness. Conclusion:Blindness from primary open-angle glaucoma was not uncommon in this population of treated patients after the long follow-up period proposed. Persistence rates with the first therapy, as measured by a medical decision to change, were low. Persistence ≤6 months was statistically associated with the development of unilateral and bilateral blindness from glaucoma.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years

Paula¹,

Furtado²,

Santos³

et al. 2012

Arq. Bras. Oftalmol.

View full text Add to dashboard Cite

show abstract

“…The variables showed a strong positive correlation as the r value was 0.95 (approximately equal to one). Studies by James C Borrow et al also showed a similar observation with a r value of 0.68 between the DDLS score and mean deviation (field testing done by Humphrey field analyser) 12…”

Section: Field Indices In Various Ddls Scoresmentioning

confidence: 57%

Correlation of Disc Damage Likelihood Scale With Field Defects in Established Glaucomas- An Anatomical Versus Functional Correlation

Rajendran¹,

Ramanathan²

2019

jebmh

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BACKGROUND Glaucoma is a chronic progressive optic neuropathy characterised by optic nerve head changes and field defects due to apoptosis of ganglion cells, with raised intraocular pressure being the most important risk factor. Traditionally Armaly's cup/disc (C/D) ratio was considered as a standard method of evaluation of optic nerve head. The Disc Damage Likelihood Scale DDLS relies on the optic nerve as a direct indicator of disease. Because the scale divides glaucomatous progression into 10 stages, it can also aid to monitor the disease progression. DDLS helps in quantification of the amount of damage that the optic nerve has sustained. This study correlates the DDLS score with the visual field indices establishing a structural and functional correlation. We wanted to analyse Disc Damage Likelihood Ratio in patients with established open angle glaucoma and to correlate it with field defects and to thereby obtain an anatomical versus functional correlation. This study also evaluates the diagnostic ability of disc damage likelihood scale in glaucoma. METHODS 50 cases of established open angle glaucoma were included in this study. For all cases visual fields were recorded by Octopus 301 using G1 program and TOP strategy. After field testing, DDLS scores were calculated after dilatation. The DDLS score and field parameters of the patients were analysed. RESULTS Of the 50 patients included in this study, 70% were on topical antiglaucoma medications and 30% had undergone trabeculectomy. DDLS score and average loss variance showed a strong positive correlation as the r value was 0.95. CONCLUSIONS Disc diameter evaluation is an important part of optic nerve head evaluation. In cases with asymmetry of the cup disc ratio between two eyes, asymmetry of the disc size should also be considered if the neuroretinal rim is healthy. Disc Damage Likelihood Scale (DDLS) is a better indicator of optic nerve head status and has strong positive correlation with visual field indices. KEYWORDS Disc Damage Likelihood Scale, Automated Perimetry, Field Defects in Glaucoma. HOW TO CITE THIS ARTICLE: Chitra MR, Ramanathan A. Correlation of disc damage likelihood scale with field defects in established glaucomas-an anatomical versus functional correlation.

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Prognostic Factors for Progression of Visual Field Damage in Patients with Normal-Tension Glaucoma

Spaeth

2007

Jpn J Ophthalmol

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Disc Damage as a Prognostic and Therapeutic Consideration in the Management of Patients with Glaucoma

Cited by 3 publications

References 13 publications

Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years

Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years

Correlation of Disc Damage Likelihood Scale With Field Defects in Established Glaucomas- An Anatomical Versus Functional Correlation

Prognostic Factors for Progression of Visual Field Damage in Patients with Normal-Tension Glaucoma

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