Enhanced Glaucoma Staging System (GSS 2) for Classifying Functional Damage in Glaucoma

• DOI: 10.1097/01.ijg.0000195932.48288.97
• Publication Date: 2005-12-23T09:04:41Z
• Authors: Paolo Brusini; Stefano Filacorda
• Keywords: Adult; Aged, 80 and over; Vision Disorders; Middle Aged; Nomograms; 03 medical and health sciences; 0302 clinical medicine; Chronic Disease; Humans; Visual Field Tests; Ocular Hypertension; Visual Fields; Glaucoma, Open-Angle; Mathematics; Aged

To introduce a new method, derived from the Glaucoma Staging System (GSS), for classifying glaucomatous visual field defects.Four sample groups composed respectively of 471 (sample #1), 128 (sample #2), 185 (sample #3), and 131 (sample #4) patients with either ocular hypertension or chronic glaucoma were considered. The GSS 2 uses both the MD and CPSD/CLV or PSD/LV perimetric indices to classify visual field defect in 6 stages and in 3 types (generalized, localized, and mixed). The formulas were determined using sample #1. A new borderline stage was created, on the basis of sample #2. The relationship between the PSD/LV and CPSD/CLV values was studied on sample #3 to verify the possibility of using the uncorrected indices instead of the CPSD/CLV. The relationship with other classification methods was studied on sample #4.The GSS 2 showed a strong level of association with the AGIS and the Hodapp-Parrish-Anderson methods in staging defect severity. A good correlation was also found with a classification based on the Bebie curve.The GSS 2 was able to correctly classify both damage severity and perimetric defect type in the sample studied, using either the corrected or uncorrected visual field indices. It is a quick and easy method, and its formulas can be introduced in any software.