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Related Experiment Videos

Neuroretinal Rim Area Change in Glaucoma Patients With Visual Field Progression Endpoints and Intraocular Pressure

Rizwan Malik1, Neil O'Leary1, Frederick S Mikelberg2

  • 1Departments of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Canada.

American Journal of Ophthalmology
|December 26, 2015
PubMed
Summary

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Glaucoma patients experiencing visual field progression had significantly faster optic nerve rim area loss. Lowering intraocular pressure (IOP) after progression was linked to a slower rate of rim area decline.

Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Optic Nerve Health

Background:

  • Open-angle glaucoma is a leading cause of irreversible blindness.
  • Monitoring optic nerve damage is crucial for glaucoma management.
  • Visual field (VF) progression is a key indicator of glaucoma advancement.

Purpose of the Study:

  • To compare the rate of optic nerve rim area change in glaucoma patients with and without a visual field progression endpoint.
  • To investigate if reducing intraocular pressure (IOP) after a visual field endpoint affects the rim area rate.

Main Methods:

  • A prospective multicenter cohort study involving 206 patients with open-angle glaucoma.
  • Evaluations included standard automated perimetry and confocal scanning laser tomography at 4-month intervals.

Related Experiment Videos

  • Multivariable analysis was used to assess the impact of IOP reduction on rim area rate, adjusting for covariates.

    • Main Results:

    • Patients reaching the visual field endpoint exhibited a significantly worse rim area rate prior to the endpoint compared to those who did not (P = .02).
    • Multivariable analysis revealed that a reduction in IOP greater than 2 mm Hg post-endpoint was strongly associated with a slower decline in rim area rate.
    • Each additional 1 mm Hg reduction in IOP correlated with an 8 × 10(-3) mm(2)/y decrease in the rim area rate decline.

    Conclusions:

    • Glaucoma patients with a visual field endpoint demonstrated a nearly threefold worse median rim area rate than those without.
    • Lower mean intraocular pressure during follow-up was independently associated with a reduced rate of optic nerve rim area decline.