Definitions of Fast Glaucoma Progression Vary Significantly Among Studies, Lack Standardization

OCT is a vital tool for detecting glaucoma progression, often identifying structural changes in the retinal nerve fiber layer (RNFL) or macula before functional vision loss appears on visual field tests. Photo: Brian D. Fisher, OD. Click image to enlarge. A systematic review found that definitions of “fast progression” in glaucoma varied widely across existing literature, producing major differences in the amount of patients classified as fast progressors.The study, presented at the 2026 ARVO Annual Meeting in Denver, evaluated how inconsistencies in progression criteria affected prevalence estimates for rapidly progressing glaucoma. The authors reviewed published definitions of fast glaucomatous progression using visual field testing, optic nerve head photography, OCT, confocal scanning laser tomography and OCT angiography.Researchers conducted the review using Medline and Embase, two medical databases. Two of the reviewers selected eligible studies and extracted complete definitions of fast progression. Each definition included both a criterion—such as mean deviation (MD) or visual field index (VFI)—and an analysis method used to determine progression rates.To assess how these varying definitions influenced prevalence, investigators applied the four most commonly used MD- and VFI-based criteria to a cohort of glaucoma patients they followed who had undergone at least six VF examinations. The authors found noticeable differences between the criteria and methods used to define “fast progression” in glaucoma studies and that, depending on which definition was applied, the number of patients identified as fast progressors differed significantly. These findings suggested that a lack of standardization may be a major contributor to complications within such studies and that it may affect both clinical decisions and research interpretation.Original abstract ©2026 Association for Research in Vision and Ophthalmology.Click here for the source. Ghirardi A, Servillo A, Patelli C, et al. Fast progression definitions in glaucoma literature and their impact on fast-progressor prevalence. May 4, 2026. ARVO 2026 annual meeting. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.