Performance of the Rule of 5 for Detecting Glaucoma Progression between Visits with OCT.

Ophthalmology. Glaucoma
Atalie C ThompsonFelipe A Medeiros

Abstract

To evaluate whether loss of 5 μm or more in global retinal nerve fiber layer (RNFL) thickness on spectral-domain (SD) between 2 consecutive visits is specific for glaucoma progression. Prospective cohort. Ninety-two eyes of 49 control participants and 300 eyes of 210 glaucoma patients. Patients completed at least 5 standard automated perimetry and SD OCT examinations at 6-month intervals over at least 2 years. Eyes were categorized as progressing from glaucoma if the average RNFL declined by 5 μm or more between 2 consecutive visits. The false-positive proportion was estimated by 2 methods: (1) 5-μm or more loss in control participants and (2) 5-μm or more gain in glaucoma. The false-positive proportion was subtracted from the cumulative proportion of eyes categorized with glaucoma progression to estimate the true progression prevalence. False-positive and true progression prevalence of patients with glaucoma detected as progressing on SD OCT. After 5 years of semiannual testing, the cumulative proportion of false-positive results based on 5-μm or more RNFL losses between visits was 24.8% in the control participants. Although 40.6% of glaucoma eyes were diagnosed with progression at 5 years, only 15.8% would have been considere...Continue Reading

Citations

Dec 5, 2020·European Journal of Ophthalmology·Delaram MirzaniaKelly W Muir
Nov 6, 2020·Translational Vision Science & Technology·Melvi D EguiaDonald C Hood
Dec 19, 2020·Journal of Glaucoma·Donald C HoodCarlos G De Moraes
May 12, 2021·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Abinaya ThenappanDonald C Hood

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