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Risk factors for visual field progression in treated glaucoma.
Carlos Gustavo V De Moraes1, Viral J Juthani, Jeffrey M Liebmann
1Einhorn Clinical Research Center, New York Eye and Ear Infirmary, 310 E 14th St, New York, NY 10003, USA.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|May 11, 2011
Summary
In treated glaucoma patients, both intraocular pressure (IOP)-dependent and independent factors influence visual field (VF) progression. Peak IOP is a stronger predictor of VF loss than mean or fluctuating IOP.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Visual Field Analysis
Background:
- Glaucoma is a leading cause of irreversible blindness.
- Understanding factors influencing visual field (VF) progression is crucial for managing treated glaucoma patients.
- Intraocular pressure (IOP) is a primary target for glaucoma management, but other factors also contribute to disease progression.
Purpose of the Study:
- To identify intraocular pressure (IOP)-dependent and IOP-independent variables associated with visual field (VF) progression in patients with treated glaucoma.
- To assess the relative importance of different IOP metrics (mean, peak, fluctuation) in predicting VF progression.
Main Methods:
- Retrospective cohort study of the Glaucoma Progression Study.
- Included 587 eyes of 587 treated glaucoma patients with repeatable VF loss and at least 8 VF examinations.
- Visual field progression evaluated using automated pointwise linear regression; data included age, central corneal thickness, disc hemorrhage, parapapillary atrophy, and various IOP parameters.
Main Results:
- Univariable analysis revealed age, exfoliation syndrome, thinner central corneal thickness, disc hemorrhage, parapapillary atrophy, and all IOP parameters were associated with increased VF progression risk.
- Multivariable analysis identified peak IOP, thinner central corneal thickness, disc hemorrhage, and parapapillary atrophy as significant predictors of VF progression.
Conclusions:
- Both IOP-dependent and IOP-independent factors significantly impact disease progression in treated glaucoma.
- Peak intraocular pressure (IOP) emerged as a more potent predictor of visual field progression compared to mean or fluctuating IOP.
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