Screening for vascular risk factors in glaucoma: the GVRF study

Area of Science:

• Ophthalmology
• Glaucoma Research
• Vascular Health

Background:

• Glaucoma, including primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and ocular hypertension (OH), is a leading cause of irreversible blindness.
• Vascular risk factors (VRF) are increasingly recognized as potential contributors to glaucoma pathogenesis and progression.
• Understanding the prevalence of VRF in different glaucoma subtypes is crucial for risk stratification and management.

Purpose of the Study:

• To determine the prevalence of vascular risk factors (VRF) in patients diagnosed with primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and ocular hypertension (OH).
• To evaluate the influence of VRF on the progression of glaucomatous visual field defects in these patient groups.

Main Methods:

• A cross-sectional prevalence study involving 269 Belgian ophthalmologists.
• Data collected via questionnaire from 4920 patients with POAG, NTG, or OH, including age, intraocular pressure, refraction, visual field defect, cup/disc ratio, medical therapy, and VRF.
• Visual field progression assessed by subjective analysis of at least three reliable automated perimetries over a minimum of three years.

Main Results:

• The study enrolled 4920 patients: 75% POAG, 8% NTG, and 17% OH, with a mean age of 67 years; 53% were female.
• A significantly higher prevalence of one or more VRF was observed in patients with POAG/NTG compared to those with OH (p < 0.01).
• Visual field progression occurred in 34% of POAG patients and 46% of NTG patients. In POAG, the presence of at least 2 or 3 VRF increased the risk of visual field progression by 16% and 42%, respectively (p=0.03 and p=0.002).

Conclusions:

• The prevalence of vascular risk factors is significantly higher in patients with primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG) compared to ocular hypertension (OH).
• The presence of vascular risk factors appears to increase the risk of progression in glaucomatous visual field defects, particularly in POAG.