Examination of the performance of different pointwise linear regression progression criteria to detect glaucomatous visual field change

Background: We aimed to investigate the performance of five different trend analysis criteria for the detection of glaucomatous progression and to determine the most frequently and rapidly progressing locations of the visual field. Design: Retrospective cohort. Participants or Samples: Treated glaucoma patients with ≥8 Swedish Interactive Thresholding Algorithm (SITA)-standard 24-2 visual field tests. Methods: Progression was determined using trend analysis. Five different criteria were used: (A) ≥1 significantly progressing point; (B) ≥2 significantly progressing points; (C) ≥2 progressing points located in the same hemifield; (D) at least two adjacent progressing points located in the same hemifield; (E) ≥2 progressing points in the same Garway-Heath map sector. Main Outcome Measures: Number of progressing eyes and false-positive results. Results: We included 587 patients. The number of eyes reaching a progression end-point using each criterion was: A=300 (51%); B=212 (36%); C=194 (33%); D=170 (29%); and E=186 (31%) (P≤0.03). The numbers of eyes with positive slopes were: A=13 (4.3%); B=3 (1.4%); C=3 (1.5%); D=2 (1.1%); and E=3 (1.6%) (P=0.06). The global slopes for progressing eyes were more negative in Groups B, C and D than in Group A (P=0.004). The visual field locations that progressed more often were those in the nasal field adjacent to the horizontal midline. Conclusions: Pointwise linear regression criteria that take into account the retinal nerve fibre layer anatomy enhances the specificity of trend analysis for the detection glaucomatous visual field progression.