Enhanced Glaucoma Staging System (GSS 2) for classifying functional damage in glaucoma

J Glaucoma. 2006 Feb;15(1):40-6. doi: 10.1097/01.ijg.0000195932.48288.97.


Purpose: To introduce a new method, derived from the Glaucoma Staging System (GSS), for classifying glaucomatous visual field defects.

Patients and methods: Four sample groups composed respectively of 471 (sample #1), 128 (sample #2), 185 (sample #3), and 131 (sample #4) patients with either ocular hypertension or chronic glaucoma were considered. The GSS 2 uses both the MD and CPSD/CLV or PSD/LV perimetric indices to classify visual field defect in 6 stages and in 3 types (generalized, localized, and mixed). The formulas were determined using sample #1. A new borderline stage was created, on the basis of sample #2. The relationship between the PSD/LV and CPSD/CLV values was studied on sample #3 to verify the possibility of using the uncorrected indices instead of the CPSD/CLV. The relationship with other classification methods was studied on sample #4.

Results: The GSS 2 showed a strong level of association with the AGIS and the Hodapp-Parrish-Anderson methods in staging defect severity. A good correlation was also found with a classification based on the Bebie curve.

Conclusions: The GSS 2 was able to correctly classify both damage severity and perimetric defect type in the sample studied, using either the corrected or uncorrected visual field indices. It is a quick and easy method, and its formulas can be introduced in any software.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Glaucoma, Open-Angle / classification*
  • Glaucoma, Open-Angle / diagnosis
  • Humans
  • Mathematics
  • Middle Aged
  • Nomograms
  • Ocular Hypertension / classification*
  • Ocular Hypertension / diagnosis
  • Vision Disorders / classification*
  • Visual Field Tests / methods*
  • Visual Fields*