Effectiveness of glaucoma diagnosis using Optical Coherence Tomography in patients with unreliable standard automated perimetry test.

• VISHAKHA NARAYAN RATHOD,*  
• Kavitha Chikkanayakanahalli,  
• Sandeep K,  
• Pavana Acharya,  
• Anusha K S

Abstract

Context: Glaucoma, a leading cause of blindness in people over 40 years old, involves progressive retinal ganglion cell loss. Early diagnosis and treatment are crucial. Visual Field (VF) testing, though essential, is subjective and variable. Optical Coherence Tomography (OCT) objectively measures nerve fiber layer thickness, aiding early-stage detection but less effective in advanced stages. OCT's objectivity benefits rural and less educated populations where Standard Automated Perimetry (SAP) results are often unreliable. Aims: 1)To determine the percentage of unreliable standard automated perimetry test. 2)To analyze the socio-demographic factors of patients with unreliable standard automated perimetry test. 3)To determine the percentage of the glaucoma diagnosis using OCT in patients with unreliable standard automated perimetry. Methods and Material: A cross-sectional observational study was conducted on 100 glaucoma suspect patients In glaucoma suspects-age,gender,locality,education,occupation&economic status was recoreded.30-2 central fast threshold visual field was done for 2 consecutive times.On OCT percentage of optic disc cupping,RNFL thinning were calculated&analysed in patients with unreliable SAP Results: Mean age group-52 ± 7 years.60% had unreliable SAP.40 cases were in age 51-70years.39 cases were from rural locality & 21 from urban.Most of them were farmers.22 cases were illiterate.50 cases were from lower socio-economic stauts.35 cases had RNFL thinning Conclusion: 60% of individuals had unreliable SAP results. Most cases of unreliable perimetry were observed in females, age group of 50-70 years, predominantly from rural areas, engaged in farming or homemaking, with low literacy levels and a lower socio-economic status. Among these individuals, 58% were diagnosed having glaucoma using OCT, highlighting the effectiveness OCT in diagnosing glaucoma in this group.

Keywords

Glaucoma, OCT , SAP, RGC, RNFL, Socio-demographic Factors, Unreliable SAP,Visual field