The Early Manifest Glaucoma Trial (EMGT) had previously demonstrated without doubt that intraocular pressure reduction decreased the risk of progression in patients with early glaucoma. In this analysis of 306 eyes over eight years from the EMGT, perimetric and optic disc progression were respectively evaluated using glaucoma change probability maps and independent assessment by three graders. Progression was detected first in the visual fields in 52% and first in the optic disc in 12%. Progression was four times more likely to be detected first in the visual fields than in the optic disc appearance. These results are not unexpected, and it would also be interesting to compare visual field progression vs. optical coherence tomography (OCT) progression over the long-term in future studies. 

Structural and functional progression in the Early Manifest Glaucoma Trial.
Ohnell HM, Heijl A, Bremner L, et al.
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Brian Ang

Royal Victorian Eye and Ear Hospital, Melbourne, Australia

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