Individualized as opposed to standardized care for glaucoma patients – the key to success. The use of the DDLS and the Colored Glaucoma Graph
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Published:
Dec 31, 2015
Keywords:
glaucoma, intraocular pressure, optic nerve head, visual field, quality of life
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Abstract
Glaucoma is first cause of irreversible blindness worldwide. Statistical data, such as that obtained from randomized clinical trials, can only rarely be appropriately applied to individual glaucoma patients. This relates to many “statistically” so called normal or abnormal parameters in every field, medical and nonmedical. One area in which the shortcomings of the standardized approach is most apparent is in regard to the diagnosis and treatment of glaucoma. In this article, we note the difficulties attendant to using the average to mean healthy and the statistically different to mean unhealthy. There is a better way, which is to use each person as her or his own control. For example, age is a poor glaucoma indicator. Yet it is essential to have a good idea of life expectancy and it is not difficult to make such an estimate by considering factors other than age. We present our outlook on the diagnostics, monitoring and prognosing the outcomes of glaucomatous neuropathy not only from the ophthalmological, but also from a humanistic point of view.
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Wasyluk J, Spaeth G. Individualized as opposed to standardized care for glaucoma patients – the key to success. The use of the DDLS and the Colored Glaucoma Graph. Ophthatherapy [Internet]. 2015Dec.31 [cited 2024Nov.22];2(4):240-57. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/649
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Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
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2. Stan Zdrowia Ludności Polski w Przekroju Terytorialnym w 2004 r. Główny Urząd Statystyczny, Zakład Wydawnictw Statystycznych, Warszawa 2007. Online: http://stat.gov.pl/cps/rde/xbcr/gus/stan_zdrowia_2004_teryt.pdf.
3. Heijl A. Perimetry, tonometry and epidemiology: the fate of glaucoma management. Acta Ophthalmol. 2011; 89(4): 309-15.
4. Asaoka R, Crabb DP, Yamashita T et al. Patients have two eyes!: binocular versus better eye visual field indices. Invest Ophthalmol Vis Sci. 2011; 52(9): 7007-11.
5. Owen VM, Crabb DP, White ET et al. Glaucoma and fitness to drive: using binocular visual fields to predict a milestone to blindness. Invest Ophthalmol Vis Sci. 2008; 49(6): 2449-55.
6. Bengtsson B, Heijl A. A visual field index for calculation of glaucoma rate of progression. Am J Ophthalmol. 2008; 145(2): 343-53.
7. Chauhan BC, Garway-Heath DF, Goñi FJ et al. Practical recommendations for measuring rates of visual field change in glaucoma. Br J Ophthalmol. 2008; 92(4): 569-73.
8. Bengtsson B, Patella VM, Heijl A. Prediction of glaucomatous visual field loss by extrapolation of linear trends. Arch Ophthalmol. 2009; 127(12): 1610-5.
9. Chauhan BC, Garway-Heath DF, Goñi FJ et al. Practical recommendations for measuring rates of visual field change in glaucoma. Br J Ophthalmol. 2008; 92(4): 569-73.
10. Broman AT, Quigley HA, West SK et al. Estimating the rate of progressive visual field damage in those with open-angle glaucoma, from cross-sectional data. Invest Ophthalmol Vis Sci. 2008; 49(1): 66-76.
11. Bengtsson B, Heijl A. A visual field index for calculation of glaucoma rate of progression. Am J Ophthalmol. 2008; 145(2): 343-53.
12. Iester MM, Wollstein G, Bilonick RA et al. Agreement among graders on Heidelberg retina tomograph (HRT) topographic change analysis (TCA) glaucoma progression interpretation. Br J Ophthalmol. 2015; 99(4): 519-23.
13. Kjaergaard SM, Alencar LM, Nguyen B et al. Detection of retinal nerve fibre layer progression: comparison of the fast and extended modes of GDx guided progression analysis. Br J Ophthalmol. 2011; 95(12): 1707-12.
14. Leung CK, Cheung CY, Weinreb RN et al. Evaluation of retinal nerve fiber layer progression in glaucoma: a study on optical coherence tomography guided progression analysis. Invest Ophthalmol Vis Sci. 2010; 51(1): 217-22.
15. Bussel II, Wollstein G, Schuman JS. OCT for glaucoma diagnosis, screening and detection of glaucoma progression. Br J Ophthalmol. 2014; 98(supl. 2): ii15-9.
16. Banegas SA, Antón A, Morilla-Grasa A et al. Agreement among spectral-domain optical coherence tomography, standard automated perimetry, and stereophotography in the detection of glaucoma progression. Invest Ophthalmol Vis Sci. 2015; 56(2): 1253-60.
17. Grewal DS, Sehi M, Greenfield DS. Detecting glaucomatous progression using GDx with variable and enhanced corneal compensation using Guided Progression Analysis. Br J Ophthalmol. 2011; 95(4): 502-8.
18. Kjaergaard SM, Alencar LM, Nguyen B et al. Detection of retinal nerve fibre layer progression: comparison of the fast and extended modes of GDx guided progression analysis. Br J Ophthalmol. 2011; 95(12): 1707-12.
19. Wasyluk J, Prost ME. Jak sprawdzić, czy leczymy jaskrę skutecznie? Przegląd współczesnych metod oceny progresji neuropatii jaskrowej. Okulistyka. 2015; 18(2): 12-7.
20. Caprioli J, Coleman AL. Intraocular pressure fluctuation a risk factor for visual field progression at low intraocular pressures in the advanced glaucoma intervention study. Ophthalmology. 2008; 115(7): 1123-9.
21. Heijl A, Leske C, Bengtsson B et al. Early Manifest Glaucoma Trial Group. Reduction of Intraocular Pressure and Glaucoma Progression. Arch Ophthalmology. 2002; 120: 1268-79.
22. Heijl A, Buchholz P, Norrgren G et al. Rates of visual field progression in clinical glaucoma care. Acta Ophthalmol. 2013; 91(5): 406-412.
23. Laemmer R, Schroeder S, Martus P et al. Quantification of neuroretinal rim loss using digital planimetry in long-term follow-up of normals and patients with ocular hypertension. J Glaucoma. 2007: 16(5): 430-36.
24. Garway-Heath DF, Wollstein G, Hitchings RA. Aging changes of the optic nerve head in relation to open angle glaucoma. Br J Ophthalmol. 1997; 81(10): 840-5.
25. Brusini P. Estimating glaucomatous anatomical damage by computerized automated perimetry. Acta Ophthalmol Scand Suppl. 1997; (224): 28-9.
26. Spaeth GL, Lopes JF, Junk AK et al. Systems for staging the amount of optic nerve damage in glaucoma: a critical review and new material. Surv Ophthalmol. 2006; 51(4): 293-315.
27. Pickard R. The alteration in size of the normal optic disc cup. Br J Ophthalmol. 1948; 32(6): 355-6.
28. Spaeth GL, Hwang S, Gomes M. Uszkodzenie tarczy nerwu wzrokowego jako prognostyczna i terapeutyczna wskazówka podczas leczenia pacjentów z jaskrą. Okulistyka. 2000; wyd. specjalne IV.
29. Read RM, Spaeth GL. The practical clinical appraisal of the optic disc in glaucoma: the natural history of cup progression and some specific disc-field correlations. Trans Am Acad Ophthalmol Otolaryngol. 1974; 78: OP255-74.
30. Weinreb RN, Greve EL (ed.). WGA Consensus Series 1, Glaucoma Diagnosis – Structure and Function. Kugler Publications, USA 2004.
31. Spaeth GL, Reddy SC. Imaging of the optic disk in caring for patients with glaucoma: ophthalmoscopy and photography remain the gold standard. Surv Ophthalmol. 2014; 59(4): 454-8.
32. Zangalli C, Gupta SR, Spaeth GL. The disc as the basis of treatment for glaucoma. Saudi J Ophthalmol. 2011; 25(4): 381-7.
33. Spaeth GL, Henderer J, Liu C et al. The disc damage likelihood scale (DDLS): its use in the diagnosis and management of glaucoma. Highlights of Ophthalmology. 2003; 31: 4-19.
34. Henderer JD. Disc damage likelihood scale. Br J Ophthalmol. 2006; 90(4): 395-6.
35. Spaeth GL, Henderer J, Liu C et al. The disc damage likelihood scale: reproducibility of a new method of estimating the amount of optic nerve damage caused by glaucoma. Trans Am Ophthalmol Soc. 2002; 100: 181-5.
36. Henderer JD, Liu C, Kesen M et al. Reliability of the Disk Damage Likelihood Scale. Am J Ophthalmol. 2003; 135(1): 44-8.
37. Hornova J, Kuntz Navarro JBV, Prasad A et al. Correlation of Disc Damage Likelihood Scale, Visual Field and Heidelberg Retina Tomograph II in Patients with Glaucoma. Eur J Ophthalmol. 2008; 18: 739-47.
38. Danesh-Meyer HV, Gaskin BJ, Jayusundera T et al. Comparison of disc damage likelihood scale, cup to disc ratio, and Heidelberg retina tomography in the diagnosis of glaucoma. Br J Ophthalmol. 2006; 90(4): 437-41.
39. Zangwill LM, Jain S, Racette L et al. The effect of disc size and severity of disease on the diagnostic accuracy of the Heidelberg Retina Tomograph Glaucoma Probability Score. Invest Ophth Vis Sci. 2007; 48(6): 2653-60.
40. Mathews PM, Ramulu PY, Friedman DS et al. Evaluation of ocular surface disease in patients with glaucoma. Ophthalmology. 2013; 120(11): 2241-8.
41. Stewart WC, Stewart JA, Nelson LA. Ocular surface disease in patients with ocular hypertension and glaucoma. Curr Eye Res. 2011; 36(5): 391-8.
42. Leung EW, Medeiros FA, Weinreb RN. Prevalence of ocularsurface disease in glaucoma patients. J Glaucoma. 2008; 17(5): 350-5.
43. Sun Y, Lin C, Waisbourd M et al. The Impact of Visual Field Clusters on Performance-Based Measures and Vision-Related Quality of Life in Patients with Glaucoma. Am J Ophthalmol. 2015 Dec 14 [Epub ahead of print].
44. Altangerel U, Spaeth GL, Steinmann WC. Assessment of function related to vision (AFREV). Ophthalm Epidemiol. 2006; 13(1): 67-80.
45. Ekici F, Loh R, Waisbourd M et al. Relationships Between Measures of the Ability to Perform Vision-Related Activities, Vision-Related Quality of Life, and Clinical Findings in Patients With Glaucoma. JAMA Ophthalmol. 2015; 133(12): 1377-85.
46. Hu CX, Zangalli C, Hsieh M et al. What do patients with glaucoma see? Visual symptoms reported by patients with glaucoma. Am J Med Sci. 2014; 348(5): 403-9.
47. Katz LJ, Steinmann WC, Kabir A et al.; SLT/Med Study Group. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma: a prospective, randomized trial. J Glaucoma. 2012; 21(7): 460-8.
48. McAlinden C. Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review. Eye. 2014; 28(3): 249-58.
49. Waisbourd M, Katz LJ. Selective laser trabeculoplasty as a first-line therapy: a review. Can J Ophthalmol. 2014; 49(6): 519-22.
50. Patel V, El Hawy E, Waisbourd M et al. Long-term outcomes in patients initially responsive to selective laser trabeculoplasty. Int J Ophthalmol. 2015; 8(5): 960-4.
51. European Glaucoma Society “Terminology and Guidelines for Glaucoma”, PubliComm 2014, Savona, Italy, 166-168.
52. Spaeth G, Walt J, Keener J. Evaluation of Quality of Life for Patients with Glaucoma. Amer J Glaucoma. 2006; 141(1): 3-13.
2. Stan Zdrowia Ludności Polski w Przekroju Terytorialnym w 2004 r. Główny Urząd Statystyczny, Zakład Wydawnictw Statystycznych, Warszawa 2007. Online: http://stat.gov.pl/cps/rde/xbcr/gus/stan_zdrowia_2004_teryt.pdf.
3. Heijl A. Perimetry, tonometry and epidemiology: the fate of glaucoma management. Acta Ophthalmol. 2011; 89(4): 309-15.
4. Asaoka R, Crabb DP, Yamashita T et al. Patients have two eyes!: binocular versus better eye visual field indices. Invest Ophthalmol Vis Sci. 2011; 52(9): 7007-11.
5. Owen VM, Crabb DP, White ET et al. Glaucoma and fitness to drive: using binocular visual fields to predict a milestone to blindness. Invest Ophthalmol Vis Sci. 2008; 49(6): 2449-55.
6. Bengtsson B, Heijl A. A visual field index for calculation of glaucoma rate of progression. Am J Ophthalmol. 2008; 145(2): 343-53.
7. Chauhan BC, Garway-Heath DF, Goñi FJ et al. Practical recommendations for measuring rates of visual field change in glaucoma. Br J Ophthalmol. 2008; 92(4): 569-73.
8. Bengtsson B, Patella VM, Heijl A. Prediction of glaucomatous visual field loss by extrapolation of linear trends. Arch Ophthalmol. 2009; 127(12): 1610-5.
9. Chauhan BC, Garway-Heath DF, Goñi FJ et al. Practical recommendations for measuring rates of visual field change in glaucoma. Br J Ophthalmol. 2008; 92(4): 569-73.
10. Broman AT, Quigley HA, West SK et al. Estimating the rate of progressive visual field damage in those with open-angle glaucoma, from cross-sectional data. Invest Ophthalmol Vis Sci. 2008; 49(1): 66-76.
11. Bengtsson B, Heijl A. A visual field index for calculation of glaucoma rate of progression. Am J Ophthalmol. 2008; 145(2): 343-53.
12. Iester MM, Wollstein G, Bilonick RA et al. Agreement among graders on Heidelberg retina tomograph (HRT) topographic change analysis (TCA) glaucoma progression interpretation. Br J Ophthalmol. 2015; 99(4): 519-23.
13. Kjaergaard SM, Alencar LM, Nguyen B et al. Detection of retinal nerve fibre layer progression: comparison of the fast and extended modes of GDx guided progression analysis. Br J Ophthalmol. 2011; 95(12): 1707-12.
14. Leung CK, Cheung CY, Weinreb RN et al. Evaluation of retinal nerve fiber layer progression in glaucoma: a study on optical coherence tomography guided progression analysis. Invest Ophthalmol Vis Sci. 2010; 51(1): 217-22.
15. Bussel II, Wollstein G, Schuman JS. OCT for glaucoma diagnosis, screening and detection of glaucoma progression. Br J Ophthalmol. 2014; 98(supl. 2): ii15-9.
16. Banegas SA, Antón A, Morilla-Grasa A et al. Agreement among spectral-domain optical coherence tomography, standard automated perimetry, and stereophotography in the detection of glaucoma progression. Invest Ophthalmol Vis Sci. 2015; 56(2): 1253-60.
17. Grewal DS, Sehi M, Greenfield DS. Detecting glaucomatous progression using GDx with variable and enhanced corneal compensation using Guided Progression Analysis. Br J Ophthalmol. 2011; 95(4): 502-8.
18. Kjaergaard SM, Alencar LM, Nguyen B et al. Detection of retinal nerve fibre layer progression: comparison of the fast and extended modes of GDx guided progression analysis. Br J Ophthalmol. 2011; 95(12): 1707-12.
19. Wasyluk J, Prost ME. Jak sprawdzić, czy leczymy jaskrę skutecznie? Przegląd współczesnych metod oceny progresji neuropatii jaskrowej. Okulistyka. 2015; 18(2): 12-7.
20. Caprioli J, Coleman AL. Intraocular pressure fluctuation a risk factor for visual field progression at low intraocular pressures in the advanced glaucoma intervention study. Ophthalmology. 2008; 115(7): 1123-9.
21. Heijl A, Leske C, Bengtsson B et al. Early Manifest Glaucoma Trial Group. Reduction of Intraocular Pressure and Glaucoma Progression. Arch Ophthalmology. 2002; 120: 1268-79.
22. Heijl A, Buchholz P, Norrgren G et al. Rates of visual field progression in clinical glaucoma care. Acta Ophthalmol. 2013; 91(5): 406-412.
23. Laemmer R, Schroeder S, Martus P et al. Quantification of neuroretinal rim loss using digital planimetry in long-term follow-up of normals and patients with ocular hypertension. J Glaucoma. 2007: 16(5): 430-36.
24. Garway-Heath DF, Wollstein G, Hitchings RA. Aging changes of the optic nerve head in relation to open angle glaucoma. Br J Ophthalmol. 1997; 81(10): 840-5.
25. Brusini P. Estimating glaucomatous anatomical damage by computerized automated perimetry. Acta Ophthalmol Scand Suppl. 1997; (224): 28-9.
26. Spaeth GL, Lopes JF, Junk AK et al. Systems for staging the amount of optic nerve damage in glaucoma: a critical review and new material. Surv Ophthalmol. 2006; 51(4): 293-315.
27. Pickard R. The alteration in size of the normal optic disc cup. Br J Ophthalmol. 1948; 32(6): 355-6.
28. Spaeth GL, Hwang S, Gomes M. Uszkodzenie tarczy nerwu wzrokowego jako prognostyczna i terapeutyczna wskazówka podczas leczenia pacjentów z jaskrą. Okulistyka. 2000; wyd. specjalne IV.
29. Read RM, Spaeth GL. The practical clinical appraisal of the optic disc in glaucoma: the natural history of cup progression and some specific disc-field correlations. Trans Am Acad Ophthalmol Otolaryngol. 1974; 78: OP255-74.
30. Weinreb RN, Greve EL (ed.). WGA Consensus Series 1, Glaucoma Diagnosis – Structure and Function. Kugler Publications, USA 2004.
31. Spaeth GL, Reddy SC. Imaging of the optic disk in caring for patients with glaucoma: ophthalmoscopy and photography remain the gold standard. Surv Ophthalmol. 2014; 59(4): 454-8.
32. Zangalli C, Gupta SR, Spaeth GL. The disc as the basis of treatment for glaucoma. Saudi J Ophthalmol. 2011; 25(4): 381-7.
33. Spaeth GL, Henderer J, Liu C et al. The disc damage likelihood scale (DDLS): its use in the diagnosis and management of glaucoma. Highlights of Ophthalmology. 2003; 31: 4-19.
34. Henderer JD. Disc damage likelihood scale. Br J Ophthalmol. 2006; 90(4): 395-6.
35. Spaeth GL, Henderer J, Liu C et al. The disc damage likelihood scale: reproducibility of a new method of estimating the amount of optic nerve damage caused by glaucoma. Trans Am Ophthalmol Soc. 2002; 100: 181-5.
36. Henderer JD, Liu C, Kesen M et al. Reliability of the Disk Damage Likelihood Scale. Am J Ophthalmol. 2003; 135(1): 44-8.
37. Hornova J, Kuntz Navarro JBV, Prasad A et al. Correlation of Disc Damage Likelihood Scale, Visual Field and Heidelberg Retina Tomograph II in Patients with Glaucoma. Eur J Ophthalmol. 2008; 18: 739-47.
38. Danesh-Meyer HV, Gaskin BJ, Jayusundera T et al. Comparison of disc damage likelihood scale, cup to disc ratio, and Heidelberg retina tomography in the diagnosis of glaucoma. Br J Ophthalmol. 2006; 90(4): 437-41.
39. Zangwill LM, Jain S, Racette L et al. The effect of disc size and severity of disease on the diagnostic accuracy of the Heidelberg Retina Tomograph Glaucoma Probability Score. Invest Ophth Vis Sci. 2007; 48(6): 2653-60.
40. Mathews PM, Ramulu PY, Friedman DS et al. Evaluation of ocular surface disease in patients with glaucoma. Ophthalmology. 2013; 120(11): 2241-8.
41. Stewart WC, Stewart JA, Nelson LA. Ocular surface disease in patients with ocular hypertension and glaucoma. Curr Eye Res. 2011; 36(5): 391-8.
42. Leung EW, Medeiros FA, Weinreb RN. Prevalence of ocularsurface disease in glaucoma patients. J Glaucoma. 2008; 17(5): 350-5.
43. Sun Y, Lin C, Waisbourd M et al. The Impact of Visual Field Clusters on Performance-Based Measures and Vision-Related Quality of Life in Patients with Glaucoma. Am J Ophthalmol. 2015 Dec 14 [Epub ahead of print].
44. Altangerel U, Spaeth GL, Steinmann WC. Assessment of function related to vision (AFREV). Ophthalm Epidemiol. 2006; 13(1): 67-80.
45. Ekici F, Loh R, Waisbourd M et al. Relationships Between Measures of the Ability to Perform Vision-Related Activities, Vision-Related Quality of Life, and Clinical Findings in Patients With Glaucoma. JAMA Ophthalmol. 2015; 133(12): 1377-85.
46. Hu CX, Zangalli C, Hsieh M et al. What do patients with glaucoma see? Visual symptoms reported by patients with glaucoma. Am J Med Sci. 2014; 348(5): 403-9.
47. Katz LJ, Steinmann WC, Kabir A et al.; SLT/Med Study Group. Selective laser trabeculoplasty versus medical therapy as initial treatment of glaucoma: a prospective, randomized trial. J Glaucoma. 2012; 21(7): 460-8.
48. McAlinden C. Selective laser trabeculoplasty (SLT) vs other treatment modalities for glaucoma: systematic review. Eye. 2014; 28(3): 249-58.
49. Waisbourd M, Katz LJ. Selective laser trabeculoplasty as a first-line therapy: a review. Can J Ophthalmol. 2014; 49(6): 519-22.
50. Patel V, El Hawy E, Waisbourd M et al. Long-term outcomes in patients initially responsive to selective laser trabeculoplasty. Int J Ophthalmol. 2015; 8(5): 960-4.
51. European Glaucoma Society “Terminology and Guidelines for Glaucoma”, PubliComm 2014, Savona, Italy, 166-168.
52. Spaeth G, Walt J, Keener J. Evaluation of Quality of Life for Patients with Glaucoma. Amer J Glaucoma. 2006; 141(1): 3-13.