Analysis of risk factors for long-term glaucomatous damage development

The aim of this study was to analyze predictors of long-term glaucoma progression.

We followed 17 primary open angle glaucoma patients (POAG) and 25 ocular hypertensives (OHT) over three years, with regular follow-up examinations of both eyes every 6 months. Glaucoma damage was quantified by optical coherence tomography (retinal nerve fiber layer - OCT RNFL) and by perimetry. Corneal and hand temperature (infrared thermometer), corneal hysteresis, pachymetry and ocular pulse amplitude (OPA) readings were taken at baseline, and applanatory intraocular pressure and retinal vessel analysis recordings were made at baseline and follow-up visits. Forward-stepwise multiple regression analysis was performed.

With OCT-RNFL progression as the dependent variable, the model selected initial diagnosis (OHT less probable of progressing), baseline RNFL thickness, retinal arterial and venous diameter and arterial flicker response as significant damage predictors. For visual field damage progression, these were: corneal temperature, OPA, initial diagnosis and venous flicker response (all p<0.05).

Initial damage and vascular factors are strong predictors of future glaucoma progression.