Structural changes may precede the development of the functional VF defects. Glaucomatous damage is characterized by structural changes of the optic nerve head (ONH) and retinal nerve fiber layer (RNFL), functional changes of the VF, and ultimate loss of central visual acuity. Glaucoma is an irreversible optic neuropathy resulting from retinal ganglion cell death that leads to progressive visual field (VF) loss. The AMAF was better than the conventional comparison method in discriminating structural changes during glaucoma progression, and showed a moderate agreement with functional progression criteria.

The rates of RNFL thickness decay using OCT were significantly different between the progressing and stable eyes when progression was determined by AMAF (−3.49☒.86 μm per year vs −1.83☓.22 μm per year P=0.007) but not by the conventional method (−3.24☒.42 μm per year vs −2.42☓.33 μm per year P=0.290). The AMAF showed better agreement than the conventional method, using GPA of the VF test ( κ=0.337 P<0.001 and κ=0.124 P=0.191, respectively). ResultsĪmong 103 eyes, 47 (45.6%), 21 (20.4%), and 32 (31.1%) eyes were evaluated as glaucoma progression using AMAF, the conventional method, and guided progression analysis (GPA) of the VF test, respectively. RNFL thickness changes measured by optical coherence tomography (OCT) were compared between progressing and stable eyes determined by each method. Progression-detecting performances of AMAF and the conventional method were evaluated by an agreement between functional and structural progression criteria. Functional progression was detected by two VF progression criteria and structural progression by both AMAF and conventional comparison methods using optic disc and retinal nerve fiber layer (RNFL) photography. Open-angle glaucoma patients with a baseline mean deviation of visual field (VF) test>−6 dB were included in this longitudinal and retrospective study. To evaluate a progression-detecting algorithm for a new automated matched alternation flicker (AMAF) in glaucoma patients.

Flicker photography