Incorporating life expectancy in glaucoma care

To calculate for which combinations of age and perimetric disease stage glaucoma patients are unlikely to become visually impaired during their lifetime.

We used residual life expectancy data (life expectancy adjusted for the age already reached) as provided by Statistics Netherlands and rates of progression as derived from published studies. We calculated the baseline mean deviation (MD) for which an individual would reach a MD of -20 dB at the end of life as a function of age and rate of progression. For situations in which the individual rate of progression is unknown, we used the 90th percentiles of rate of progression and residual life expectancy. For situations in which the individual rate of progression is known, we used the 95th percentile of the residual life expectancy.

An easily applicable graphical tool was developed that enables an accurate estimate of the probability of becoming visually impaired during lifetime, given age, current glaucomatous damage, and--if available--the individual rate of progression.

This novel tool enables the clinician to incorporate life expectancy in glaucoma care in a well-founded manner and may serve as a starting point for personalized decision making.