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Relationship between visual field progression and baseline refraction in primary open-angle glaucoma.

Tomoko Naito1, Keiji Yoshikawa2, Shiro Mizoue3

  • 1Department of Ophthalmology, Okayama University Graduate School of Medicine, Okayama, Japan.

Clinical Ophthalmology (Auckland, N.Z.)
|August 19, 2016
PubMed
Summary

In Japanese patients with primary open-angle glaucoma (POAG), higher baseline refraction was linked to worse visual field (VF) progression. Myopia was associated with less severe VF deterioration, suggesting refraction influences glaucoma outcomes.

Keywords:
MD slopeintraocular pressure reduction ratemyopianormal-tension glaucomaprimary open-angle glaucomarefractionvisual field progression

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Area of Science:

  • Ophthalmology
  • Glaucoma Research
  • Refractive Error Studies

Background:

  • Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide.
  • Visual field (VF) progression is a key indicator of glaucoma severity and treatment efficacy.
  • The influence of baseline refractive error on VF progression in POAG remains an area of active investigation.

Purpose of the Study:

  • To investigate the association between baseline refraction and the rate of visual field (VF) progression in Japanese patients diagnosed with primary open-angle glaucoma (POAG).
  • To determine if refractive error, including myopia, influences the deterioration of the mean deviation (MD) slope in POAG patients.

Main Methods:

  • A retrospective analysis of 156 Japanese POAG patients who underwent at least ten Humphrey Visual Field tests.
  • Visual field progression was defined by a significantly negative mean deviation (MD) slope.
  • Multivariate logistic regression models were employed to assess the relationship between baseline refraction, intraocular pressure reduction rate, and MD slope deterioration.

Main Results:

  • Significant VF progression (deterioration of MD slope) was observed in 44.9% of the analyzed eyes.
  • Eyes with VF progression exhibited significantly higher baseline refraction compared to those without progression (-1.9±3.8 D vs -3.5±3.4 D).
  • Increasing severity of myopia correlated with a decreasing trend in MD slope deterioration (P=0.0002). Baseline refraction (OR: 1.13) and IOP reduction rate (OR: 0.97) were significantly associated with MD slope deterioration.

Conclusions:

  • Baseline refraction is a significant factor associated with visual field (VF) slope deterioration in Japanese POAG patients.
  • Myopic patients demonstrated less VF deterioration compared to emmetropic or hyperopic individuals.
  • These findings highlight the role of refractive error in glaucoma progression and suggest potential differences in disease management strategies based on refractive status.