الفهرس | Only 14 pages are availabe for public view |
Abstract Glaucoma is a disease that requires a clinical diagnosis. There is no gold standard for the presence or progression of the disease. Because of the lack of a definitive measure, it is difficult to have certainty with regard to the relative sensitivities and specificities of either our current structural or functional techniques. Clearly, advances in functional and structural evaluation techniques provide more objective documentation and precision for diagnosis and progression detection than the more subjective and coarse methods of the past. Structural imaging technology (OCT) have proven to provide clinicians at all levels with the ability to assess the optic nerve and RNFL in a standardized, objective and quantitative fashion. Correspondence between structural and functional assessment allows higher certainty for the health or glaucomatous status or for stability or glaucoma progression. Our cross-sectional study has shown that the correlation between detectable structural and functional damage and change in early glaucoma is at best modest. It is important to include both structural and functional examinations for assessment of glaucoma at each stage of the disease. Our recommendation is to continue this work including; larger number of POAG patients, glaucoma suspects, normal age-matched population & to follow-up the patients to evaluate the predictive value of OCT. This is a rapidly evolving field for the development of both structural and functional technologies. We are likely to see further technological advances to permit earlier detection of disease and its progression with higher levels of certainty than currently available, yet clinical evaluation & assessment will always remain the main guide for proper diagnosis & management of glaucoma. |