Continued visual field progression in eyes with prior visual field progression in patients with open-angle glaucoma

To evaluate continued visual field (VF) progression in eyes with prior VF progression from open-angle glaucoma, using event-based criteria.

Retrospective observational case series of 70 eyes (70 patients) with open-angle glaucoma, treated for at least 2 years, that had earlier shown 1 step of VF progression. Further VF progression required a worsening of 3 adjacent points at the same location on 2 consecutive VF tests. Potential risk factors for continued progression were evaluated.

The mean follow-up was 127±43 months. Thirty-seven eyes (55%) continued to progress. At 5, 10, and 15 years after the initial VF, the Kaplan-Meier estimate of the risk of developing 2 steps of progression was 18%, 53%, and 71%. A shorter time to the first step of progression was significantly associated with further progression (P<0.001), as was slope of the VF mean deviation (P<0.001) and pattern standard deviation (P=0.041). Eyes with further progression had higher mean IOP after the first step of progression (P=0.026). Among 37 eyes with 2 steps of progression, the estimate of the risk of progressing further was 32% at 10 years after the initial VF.

Eyes with a relatively shorter time to initial VF progression from open-angle glaucoma are likely to continue to progress over long-term follow-up. More aggressive treatment in such eyes might reduce the likelihood of further VF progression.