Predictive value of confocal scanning laser for the onset of visual field loss in glaucoma suspects

Abstract

Purpose: To perform a longitudinal multivariate analysis of the ability of Moorfields Regression Analysis (MRA) to predict the onset of glaucoma in a population of patients with suspected glaucoma due to appearance of the optic nerve head.

Design: Prospective longitudinal evaluation of a diagnostic test.

Participants: Single, randomly selected eye of prospectively recruited patients with suspected glaucoma based on the optic nerve head appearance on stereophotographs and normal baseline visual field results.

Methods: The MRA was evaluated at baseline (Heidelberg Retina Tomograph; Heidelberg Engineering, Dossenheim, Germany), and visual field tests were repeated every 6 months. A longitudinal multivariate proportional hazard ratio (HR) analysis was performed, and likelihood ratios and positive and negative predictive values were compared.

Main outcome measures: Onset of visual field losses.

Results: The study included 230 eyes that were followed up during a mean period of 62±14 months, ranging from 4 to 7 years. The predicted HR (for onset of visual field losses) of the MRA temporal-inferior sector outside normal limits was 3.65 (95% confidence interval [CI], 2.32-5.75; P < 0.0001). An MRA temporal-superior sector outside normal limits had an HR of 3.43 (95% CI, 2.21-5.32; P < 0.0001).

Conclusions: The temporal-inferior and temporal-superior positions of the MRA are highly predictive for the onset of visual field loss in glaucoma suspects.