The combination of OCT and VF greatly improved detection of glaucoma worsening.

The combination of OCT and VF greatly improved detection of glaucoma worsening. Photo: Jack Phu, OD, PhD. Click image to enlarge.

In an effort to compare the accuracy of detecting moderate and rapid rates of glaucoma worsening over a two-year period with different numbers of OCT scans and VFs in a large sample of glaucoma patients and suspects, researchers recently reported in Ophthalmology that more frequent OCT scans and VFs are needed to improve the accuracy of diagnosing glaucoma progression.

The study’s OCT sample consisted of 12,150 eyes from 7,392 adult patients with glaucoma or suspected of glaucoma followed at the Wilmer Eye Institute from 2013 to 2021. The VF sample consisted of 20,583 eyes from 10,958 adult patients from the same database. All eyes had at least five measurements over follow-up, from Zeiss Cirrus OCT or the Humphrey Field Analyzer.

Accuracy was less than 50% for both OCT and VF when diagnosing disease worsening after a two-year period. OCT accuracy was 5% to 10% higher than VF accuracy at detecting moderate worsening and 10% to 15% higher for rapid worsening. Accuracy increased by over 17% when using both OCT and VF to detect worsening.

“Accuracy greatly increases when relying on both OCT and VF to detect worsening,” the study authors concluded in their paper.

Bradley C, Herbert P, Hou K, et al. Comparing the accuracy of peripapillary OCT scans and visual fields to detect glaucoma worsening. Ophthalmology. February 5, 2023. [Epub ahead of print].