Clinicians still monitoring glaucoma patients with the tried-and-true optic disc assessment should consider investing in an OCT, according to new research. A team of investigators at UCLA’s Jules Stein Eye Institute recently tested the two tools head-to-head and found baseline OCT predicted visual field progression better than cup-to-disc ratio and disc damage likelihood scores.

Researchers included 171 eyes of 95 patients with retinal nerve fiber layer (RNFL) and macular OCT readings, as well as disc photos, at baseline and at least two years of follow-up. Study participants also had visual field data for at least five years. The researchers noted 17 eyes progressed by the final follow-up based on pointwise event analysis, while 25 were identified as progressors by visual field index trend analysis. Several factors predicted visual field progression, including thinner central corneal thickness and average peripapillary RNFL, as well as female gender.

In addition, the team found a higher baseline visual field index, in conjunction with either a thinner baseline RNFL or thinner average ganglion cell-inner plexiform layer was predictive of visual field progression.

Neither the cup-to-disc ratio nor the disc damage likelihood scores predicted progression in any of these models, the researchers said in the study.

“OCT-based structural measures should be included in prognostic models of glaucomatous visual field deterioration,” the researchers concluded.

Daneshvar R, Yarmohammadi A, Alizadeh R, et al. Prediction of glaucoma progression with structural parameters: comparison of optical coherence tomography and clinical disc parameters. Am J Ophthalmol. June 25, 2019. [Epub ahead of print].