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Purpose To compare rim area rates in patients with and without the visual field (VF) progression endpoint in the Canadian Glaucoma Study and determine whether intraocular pressure (IOP) reduction following the endpoint altered rim area rate. Design Prospective multicenter cohort study. Methods setting: University hospitals. patient population: Two hundred and six patients with open-angle glaucoma were examined at 4-month intervals with standard automated perimetry and confocal scanning laser tomography. intervention: After the endpoint, IOP was reduced by ≥20%. outcome measures: Univariate analysis for change in rim area rate and multivariable analysis to adjust for independent covariates (eg, age, sex, and IOP). Results Patients with an endpoint (n = 59) had a worse rim area rate prior to the endpoint compared to those without (n = 147; median [interquartile range]: −14 [−32, 11] × 10 −3 mm 2 /y and −5 [−14, 5] × 10 −3 mm 2 /y, respectively, P = .02). In univariate analysis, there was no difference in rim area rate before and after the endpoint (median difference [95% CI], 8 (−10, 24) × 10 −3 mm 2 /y), but the muItivariate analysis showed that IOP reduction >2 mm Hg after the endpoint was strongly linked to a reduction in rim area rate decline (8 × 10 −3 mm 2 /y for each additional 1 mm Hg reduction). Conclusions Patients with a VF endpoint had a median rim area rate that was nearly 3 times worse than those without an endpoint. Lower mean follow-up IOP was independently associated with a slower decline in rim area.

Background: To determine the suitability and accuracy of the Heidelberg Retina Tomograph II (HRT II) scanning laser ophthalmoscope for identification of preferred retinal loci (PRLs) in patients with age-related macular degeneration (AMD). Methods: Fixation location was assessed prospectively in 9 eyes by 3 methods: the HRT II, a retinal camera equipped with a fixation target, and grid macular perimetry.Two testing protocols were also used: using an HRT protocol for disc location analysis and an HRT protocol for macular fixation analysis. Results: Locations of PRLs on retinal quadrants identified by all 3 methods were identical in 7 of 9 (78%) cases (McNemar χ 2 test, p = 0.48, κ = 0.78, at 95% confidence interval) with both testing protocols. Eccentric location coordinates for PRLs were not significantly different by testing modality when using either the disc location protocol ( R = 0.47, p = 0.20 [ t 7 = 1.4], y = 0.29 x + 3.29) or the macular fixation protocol ( R = 0.44, p = 0.23 [t 7 = 1.3], y = 0.31 x + 3.23). Interpretation: Eccentric locations of the optic disc on recorded video frames with the HRT II correspond to eccentric locations of PRLs in patients with AMD.