Factors associated with long-term progression or stability in primary open-angle glaucoma.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Clinical Trials

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Long-term management strategies aim to prevent disease progression and preserve visual function.
• Understanding risk factors is essential for personalized treatment approaches.

Purpose of the Study:

• To identify long-term risk factors associated with disease progression or stability in patients diagnosed with primary open-angle glaucoma.
• To evaluate the effectiveness of intraocular pressure (IOP) management in preventing POAG progression.

Main Methods:

• Retrospective analysis of consecutively reviewed patients with POAG for at least 5 years.
• Multicenter trial evaluating historical and clinical factors for association with glaucoma stability or progression.
• Comparison of intraocular pressure (IOP) levels and variability between stable and progressed groups.

Main Results:

• Of 218 patients, 34 progressed and 184 remained stable.
• Progressed group had higher mean IOP (19.5 mmHg vs. 17.2 mmHg, P=.001) and greater IOP variability (SD 5.1 mmHg vs. 3.9 mmHg, P=.012).
• Risk factors for progression included larger cup-to-disk ratio, more medications, older age, and worse visual acuity.

Conclusions:

• Lowering intraocular pressure is important for managing primary open-angle glaucoma, but not uniformly effective in preventing long-term progression.
• Identified risk factors do not refine specific IOP targets for preventing glaucoma worsening.
• Further research may be needed to optimize POAG management strategies.