The collaborative initial glaucoma treatment study: baseline visual field and test-retest variability

Invest Ophthalmol Vis Sci. 2003 Jun;44(6):2613-20. doi: 10.1167/iovs.02-0543.

Abstract

Purpose: To compare the baseline Collaborative Initial Glaucoma Treatment Study (CIGTS) visual field (VF) score and mean deviation (MD), investigate test-retest variability, and identify variables associated with VF loss and VF measurement variability.

Methods: Baseline data from a randomized clinical trial of 607 patients with newly diagnosed open-angle glaucoma were collected at 14 clinical centers. The CIGTS VF score and MD were obtained from 24-2 VF tests (Zeiss-Humphrey Systems, Dublin, CA) at two visits approximately 2 weeks apart.

Results: Although most baseline CIGTS VF scores showed limited field loss, 15% (91/607) of patients showed a substantial deficit (VF score >10 on a 0-20 scale). A small but significant learning effect was seen over the two baseline measures for CIGTS VF score and MD. CIGTS VF score and MD correlate highly (r = -0.93); both have high test-retest correlation (0.83 and 0.91, respectively). Variables associated with greater baseline VF loss for both CIGTS VF score and MD include (probabilities for VF only): male sex (P = 0.018), black race (P <or= 0.0001), lower visual acuity (P <or= 0.0001), higher intraocular pressure if more than 30 mm Hg (P = 0.0034), poor field reliability score (P <or= 0.0001), cardiovascular disease (P = 0.015), reduced patient-reported alertness (P = 0.023), and CIGTS clinical center (P <or= 0.0001). Predictors of increased CIGTS VF score variability include a midrange VF score (P <or= 0.0001), first-tested eye (P = 0.0027), reduced patient-reported alertness (P = 0.0177), increasing age (P = 0.0040), current smoker (P = 0.0014), and CIGTS clinical center (P = 0.0215).

Conclusions: The CIGTS VF score provides a measure of VF strikingly similar to the MD. Variables associated with VF loss and VF variability may help identify patients who need greater clinical scrutiny.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Antihypertensive Agents / therapeutic use
  • Female
  • Glaucoma, Open-Angle / diagnosis*
  • Glaucoma, Open-Angle / therapy*
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Observer Variation
  • Reproducibility of Results
  • Trabeculectomy
  • Vision Disorders / diagnosis*
  • Vision Disorders / therapy
  • Visual Field Tests / standards*
  • Visual Fields*

Substances

  • Antihypertensive Agents