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Abstract

  Measuring disease progression is vital in the management of patients with glaucoma and ocular hypertension.
  Progression may be assessed by structure (optic disc photography or semi-automated imaging devices) and function (perimetry).
  Progression strategies may be subdivided into “event analyses” (progression requires a predetermined threshold to be exceeded) and “trend analyses” (the behaviour of the parameter over time is monitored).
  Stereophotographic examination is prone to high inter-observer variability.
  Amongst imaging devices, the HRT has the most published longitudinal data, as it has been commercially available for the longest time and its software is “backward compatible”.
  Two progression algorithms are currently available in the HRT software: “trend analysis” and “topographical change analysis”.
  To date there are no statistically supported progression algorithms in the OCT or GDx-VCC operational software.
  There is poor concordance between HRT and visual field progression. The reasons for this remain unclear.

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