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Guided Progression Analysis™ (GPA)for GDx
GPATM
Progression tools can help
Helps address key clinical needs:
Identifying RNFL progression Determining rate of progression Assessing treatment effectiveness
Why GPATM Progression Analysis for GDx
GDx is ideal for measuring Progression. Excellent reproducibility 1
Operator independence 1 Large images allow precise scan alignment
Why GPATM Progression Analysis for GDx
1Frenkel, Slonim, et al. Operator learning effect and interoperator reproducibility of the scanning laser polarimeter with variable corneal compensation. Ophthalmology. 2005 Feb;112(2):257-61
= Possible Progression
= Likely Progression
(design specificity 95%)
with clear, concise summary of Progression.
Identify progressing patients
Simulated data.
Identify progressing patients
using three approaches for varying defect shapes
Diffuse defects
TSNIT Progression Graph
Image Progression Map
Summary Parameter Chart
Simulated data.
Deep, narrow focal defects
Shallower, broader focal defects
to identify patients at risk.
Determine the rate of progression
Simulated data.
by comparing rates before and after treatment.
Assess treatment effectiveness
Before:
-3.9 microns/yr ± 1.1
After:
-1.8 microns/yr ± 1.1
Simulated data.
Minimum cluster size is 150 pixels (2% of image area)
95% design specificity
Image Progression Map: For deep, narrow focal defects
Simulated data.
Divides ring around optic nerve into 64 segments
3 adjacent segments must show change.
95% design specificity
TSNIT Progression Graph: For broader, shallow focal defects
Simulated data.
Regression line drawn for Likely Progression and p<5%
95% design specificity
Parameter Progression Charts: For diffuse defects
TSNIT Average, Superior Average, and Inferior Average
Simulated data.
Courtesy of Robert N. Weinreb, MDFelipe A. Medeiros, MD, PhDHamilton Glaucoma Center
University of California at San Diego
GDx Progression: Case Examples
Example 1: deep, narrow focal defect
Deep, narrow wedge defect (~10 degrees)
Only identified by Image Progression Map
Data presented using research format.
Example 2: shallow, broad focal defect
Shallow inferior defect
Only identified by TSNIT Progression Graph
Data presented using research format.
Example 3: larger defect identified by all
Inferior defect
Sufficient area and depth to be identified by all three approaches
Data presented using research format.
Extending GPATM across structure and function
GPATM
tools integrate your structure and function analysis by using consistent terms and rules.
GPATM
Progression for GDx
GPA™ Progression Analysis for GDx is a comprehensive, simple tool to help you:
Make more confident treatment decisions Effectively educate patients
Summary