Baseline prognostic factors predict rapid visual field deterioration in glaucoma.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Analysis

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness.
• Identifying patients at risk for rapid visual field deterioration is crucial for timely intervention.
• Baseline prognostic factors can help predict disease progression in POAG.

Purpose of the Study:

• To identify baseline prognostic factors associated with rapid visual field deterioration in POAG patients.
• To stratify risk for faster disease progression in a large cohort of glaucoma patients.

Main Methods:

• Utilized data from 767 eyes of 566 POAG patients from AGIS and Jules Stein Eye Institute.
• Employed pointwise exponential regression analysis (PER) to calculate visual field decay rates.
• Defined rapid progressors as those with a faster component decay rate (≥ 36%/y) and used logistic regression to analyze baseline factors.

Main Results:

• 28.9% of eyes were identified as rapid progressors.
• Worse mean deviation (MD), larger vertical cup-to-disc ratio, and older age were significant predictors of faster deterioration.
• African Americans had a 54% greater likelihood of being rapid progressors compared to Caucasians, independent of glaucoma severity.

Conclusions:

• Patients with more severe glaucomatous damage (visual field and optic disc cupping) and older age are at highest risk for rapid vision loss.
• African American ethnicity is an independent risk factor for rapid POAG progression.
• Aggressive treatment strategies should be considered for high-risk patients to prevent visual disability.