Although most glaucoma patients and suspects under routine care had slow rates of progression, a substantial proportion had rates that could potentially result in major ocular consequences if sustained over time, a recent study suggests.

This retrospective study evaluated 29,548 spectral-domain OCT (SD-OCT) and 19,812 perimetry images of 6,138 eyes of 3,669 patients.

The team observed average rates of change of -0.73±0.80μm/year for global retinal nerve fiber layer thickness and -0.09±0.36dB/year for perimetry mean deviation. They classified 26.6% and 9.1% of eyes as having at least a moderate rate of change and 31.6% and 26.5% as progressing at moderate or faster rates based on SD-OCT and visual fields, respectively. They noted that most eyes classified as fast by SD-OCT were classified as slow by perimetry and vice-versa.

“Both structural and functional tests should be used to monitor glaucoma, and SD-OCT still has a relevant role in detecting fast progressors in advanced disease,” the study authors concluded in their paper.

Jammal AA, Thompson AC, Mariottoni EB, et al. Rates of glaucomatous structural and functional change from a large clinical population: the Duke Glaucoma Registry Study. Am J Ophthalmol. May 23, 2020. [Epub ahead of print].