Diagnosis of glaucoma was based on three aspects: the eye fundus, the visual field results, and the IOP. At the beginning, subjects were categorized as definite, probable, possible, or no glaucoma based on eye fundus. Subsequently, for the probable and possible subjects, if there were glaucomatous visual field defects and if the IOP was >21 mmHg, they would be diagnosed as glaucoma.
Glaucomatous visual field defects had at least two of the following characteristics: (1) a cluster of three points with a probability less than l% on a pattern deviation map in at least one hemifield, including at least one point with a probability less than 1%; or a cluster of two points with a probability less than 1%. (2) glaucoma hemifield test results outside 99% of the age-specific normal limits. (3) pattern standard deviation outside 95% of the normal limits.
Specifically, the eye fundus reading followed the following process. Firstly, four ophthalmologists from Beijing Tongren Hospital (YZ, JH, QZ, and ZG) reviewed disc photographs for vertical cup/disc ratios, rim of optic disc, nerve fiber layer defect, and optic disk hemorrhage. Secondly, independent review of the finding was carried out by three senior glaucoma specialists (TR, BSW, and YBL), classified the patients according to the same definitions. If the results differed among three specialists, a third independent reading was conducted by another glaucoma specialist (DSF). The final diagnosis was determined by another glaucoma specialist (NLW) if some confused diagnosis still existed in the third step.
Glaucoma was also diagnosed as present in cases where the optic nerve was not visible due to media opacity and the VA was <20/400 and the IOP was >99.5th percentile, or the VA was <20/400 and the eye had evidence of prior glaucoma filtering surgery, or medical records were available confirming glaucomatous visual morbidity.
Glaucomatous visual field defects had at least two of the following characteristics: (1) a cluster of three points with a probability less than l% on a pattern deviation map in at least one hemifield, including at least one point with a probability less than 1%; or a cluster of two points with a probability less than 1%. (2) glaucoma hemifield test results outside 99% of the age-specific normal limits. (3) pattern standard deviation outside 95% of the normal limits.
Specifically, the eye fundus reading followed the following process. Firstly, four ophthalmologists from Beijing Tongren Hospital (YZ, JH, QZ, and ZG) reviewed disc photographs for vertical cup/disc ratios, rim of optic disc, nerve fiber layer defect, and optic disk hemorrhage. Secondly, independent review of the finding was carried out by three senior glaucoma specialists (TR, BSW, and YBL), classified the patients according to the same definitions. If the results differed among three specialists, a third independent reading was conducted by another glaucoma specialist (DSF). The final diagnosis was determined by another glaucoma specialist (NLW) if some confused diagnosis still existed in the third step.
Glaucoma was also diagnosed as present in cases where the optic nerve was not visible due to media opacity and the VA was <20/400 and the IOP was >99.5th percentile, or the VA was <20/400 and the eye had evidence of prior glaucoma filtering surgery, or medical records were available confirming glaucomatous visual morbidity.
