Risk Factors for Fast Visual Field Progression in Glaucoma.

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Analysis

Background:

• Open-angle glaucoma is a leading cause of irreversible blindness.
• Early identification of progressive cases is crucial for timely intervention.
• Understanding risk factors for visual field decay can improve patient management.

Purpose of the Study:

• To identify baseline and longitudinal risk factors associated with rapid visual field (VF) decay in open-angle glaucoma patients.
• To investigate predictors of fast glaucomatous progression.

Main Methods:

• Retrospective cohort study including 1317 eyes from 745 patients with open-angle glaucoma.
• Visual field decay rates measured using mean deviation (MD) rate, VF index (VFI) rate, and Glaucoma Rate Index (GRI).
• Linear mixed models and logistic regression analyzed relationships between clinical variables and VF decay rates.

Main Results:

• Older age, higher peak intraocular pressure (IOP), and glaucoma surgery were associated with faster VF decay.
• Worse baseline MD and pseudoexfoliative glaucoma were linked to faster progression by specific metrics.
• Fast progressors exhibited significantly higher peak IOP compared to non-fast progressors.

Conclusions:

• Older age, peak IOP, pseudoexfoliative glaucoma, and baseline MD are associated with the rate of glaucomatous VF worsening.
• Higher peak IOP is a significant predictor of fast glaucomatous progression.
• Targeted identification and aggressive treatment of fast-progressing glaucoma patients can mitigate visual disability.