ArticleOphthalmology. Glaucoma
Performance of the Rule of 5 for Detecting Glaucoma Progression between Visits with OCT.
Article in Ophthalmology. Glaucoma. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 19 citations in OpenAlex.
- Association of serum TIM-3 and Galectin-9 levels with glaucoma progression: implications for clinical monitoring.American journal of translational research · 2026Article
- Quantitative Analysis of Retinal Nerve Fiber Layer Thickness Using SPECTRALIS Glaucoma Module Premium Edition and SPECTRALIS Standard Glaucoma Module.Translational vision science & technology · 2025Article
- Progression of Early Glaucomatous Damage: Performance of Summary Statistics From Optical Coherence Tomography and Perimetry.Translational vision science & technology · 2023Article
- Effect of Testing Frequency on the Time to Detect Glaucoma Progression With Optical Coherence Tomography (OCT) and OCT Angiography.American journal of ophthalmology · 2023Observational
- Did the OCT Show Progression Since the Last Visit?Journal of glaucoma · 2021Article
- Reasons why OCT Global Circumpapillary Retinal Nerve Fiber Layer Thickness is a Poor Measure of Glaucomatous Progression.Translational vision science & technology · 2020Article
- Macular imaging with optical coherence tomography in glaucoma.Survey of ophthalmologyReview
- Deep Learning-Assisted Detection of Glaucoma Progression in Spectral-Domain OCT.Ophthalmology. GlaucomaArticle
- Comparing the Rule of 5 to Trend-based Analysis for Detecting Glaucoma Progression on OCT.Ophthalmology. GlaucomaArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
purposeTo evaluate whether loss of 5 μm or more in global retinal nerve fiber layer (RNFL) thickness on spectral-domain (SD) between 2 consecutive visits is specific for glaucoma progression.
designProspective cohort.
participantsNinety-two eyes of 49 control participants and 300 eyes of 210 glaucoma patients.
methodsPatients completed at least 5 standard automated perimetry and SD OCT examinations at 6-month intervals over at least 2 years. Eyes were categorized as progressing from glaucoma if the average RNFL declined by 5 μm or more between 2 consecutive visits. The false-positive proportion was estimated by 2 methods: (1) 5-μm or more loss in control participants and (2) 5-μm or more gain in glaucoma. The false-positive proportion was subtracted from the cumulative proportion of eyes categorized with glaucoma progression to estimate the true progression prevalence.
main outcome measuresFalse-positive and true progression prevalence of patients with glaucoma detected as progressing on SD OCT.
resultsAfter 5 years of semiannual testing, the cumulative proportion of false-positive results based on 5-μm or more RNFL losses between visits was 24.8% in the control participants. Although 40.6% of glaucoma eyes were diagnosed with progression at 5 years, only 15.8% would have been considered to show true progression based on the expected false-positive ratio from the control participants (i.e., 40.6%-24.8%). The cumulative proportion of an intervisit gain of 5 μm or more at 5 years was 27.4% in glaucoma eyes, suggesting that only 13.2% of eyes with glaucoma truly had progressed (i.e., 40.6%-27.4%).
conclusionsLoss of 5 μm or more in average RNFL thickness between consecutive SD OCT tests is not specific for glaucoma progression. Application of this intervisit rule of 5 can result in a high cumulative proportion of false-positive results over time, which could lead to unnecessary interventions in patients whose disease is stable. More specific diagnostic criteria are needed to help clinicians determine whether patients with glaucoma are progressing so that therapy escalation is both timely and appropriate.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.