Twenty-year outcomes in patients with newly diagnosed glaucoma: mortality and visual function

Area of Science:

• Ophthalmology
• Public Health

Background:

• Chronic open-angle glaucoma (COAG) is a leading cause of irreversible blindness.
• Long-term outcomes regarding mortality and visual progression in COAG patients are crucial for clinical management.

Purpose of the Study:

• To determine the 20-year mortality rate in a cohort of patients diagnosed with COAG.
• To assess visual acuity and visual field progression over a 20-year follow-up period in COAG patients.

Main Methods:

• A retrospective audit of medical records for 436 patients diagnosed with COAG.
• Kaplan-Meier survival analysis was used to calculate mortality probability.
• Visual field severity was graded using a nine-stage scale, and visual acuity was analyzed at 20 years.

Main Results:

• Of 68 patients followed for 20 years, 37% were alive; 63% had died, with vascular disease being the most common cause.
• Patients who died were older at presentation and had worse final visual acuity compared to survivors.
• Nearly half of eyes showed no visual field deterioration, but 28.3% deteriorated by more than two stages.

Conclusions:

• Mortality is high within 20 years for COAG patients, with older age at diagnosis being a risk factor.
• Despite mortality, the goal of preventing severe visual impairment and blindness is largely achievable for most older COAG patients at the 20-year mark.