A better way to assess glaucoma?

Key Takeaways

  • A diagnostic approach that clusters multiple tests over 6 months has the potential to identify patients likely to have fast-progressing glaucoma.
  • The new approach may be useful in clinical trials and identifying fast progressing eyes at greatest risk for vision loss from glaucoma.

A diagnostic approach that clusters multiple tests of visual field and retinal imaging in an intense 6 month period has demonstrated the potential to identify patients likely to have fast-progressing glaucoma, according to a prospective cohort study presented on March 2, 2024, at the annual meeting of the American Glaucoma Society in Huntington Beach, California. The Fast-PACE study included 125 eyes of 65 patients with primary open-angle glaucoma (POAG) before significant anatomical and visual deterioration occurred, who had two clusters of testing 6 months apart. Each cluster consisted of five separate office visits in which the patients were tested for visual field (VF) defects, and had their eyes imaged with optical coherence tomography (OCT) to assess the integrity of the optic nerve. 

Felipe Medeiros, MD, PhD, told Medscape Medical News that “a clustered testing approach was able to identify fast progression in glaucoma in only 6 months. This is a remarkable result as it will lead to much faster trials.  Also, application in clinical practice will result in prompt identification of those fast progressing eyes at greatest risk for vision loss.” Identifying fast progressors in POAG has been a challenge because patients don’t get visual field testing frequently enough. He added that analyzing the results of the clustered visual field testing showed changes that would not be evident with a less frequent interval between tests and the method proved highly reliable.  The study was published recently in Ophthalmology.

Medeiros acknowledged the challenge in getting patients to have so many tests, and that clinics are already very busy. “However, our study establishes a framework that demonstrates what is possible. We now know that is possible to detect glaucoma progression in a short period of time,” Medeiros said. “Before this study, no one had demonstrated that this was possible.”

The study received support from a National Institutes of Health grant.

Source: Richard Mark Kirkner, Medscape Medical News, March 8, 2024; see source article