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The Association between Medication Adherence and Visual Field Progression in the Collaborative Initial Glaucoma
Paula Anne Newman-Casey1, Leslie M Niziol1, Brenda W Gillespie2
1Department of Ophthalmology and Visual Sciences, Medical School, University of Michigan, Ann Arbor, Michigan.
Ophthalmology
|January 15, 2020
Summary
Poor medication adherence in glaucoma patients significantly worsens vision loss over time. Consistent use of glaucoma medications is crucial for preserving visual field, as nonadherence is linked to accelerated glaucomatous progression.
Area of Science:
- Ophthalmology
- Clinical Trials
- Glaucoma Research
Background:
- The Collaborative Initial Glaucoma Treatment Study (CIGTS) evaluated treatments for newly diagnosed glaucoma.
- This study focused on participants randomized to topical medication treatment.
Purpose of the Study:
- To assess the relationship between medication adherence and visual field progression in glaucoma patients.
- To determine if adherence to topical glaucoma medications impacts disease progression.
Main Methods:
- Longitudinal analysis of 307 participants in the CIGTS medication arm over up to 10 years.
- Self-reported medication adherence assessed via telephone interviews.
- Visual field progression measured by mean deviation (MD) and analyzed using linear mixed regression models.
Main Results:
- Worse medication adherence was significantly associated with greater mean deviation (MD) loss over time (P=0.005).
- Patients missing medication doses at two-thirds of visits showed a predicted MD loss of 2.23 dB over 8 years, compared to 0.62 dB for those never missing doses.
- A clear dose-response relationship was observed between nonadherence and the rate of visual field loss.
Conclusions:
- Medication nonadherence is a significant risk factor for glaucomatous vision loss.
- Maintaining high medication adherence is critical for slowing disease progression in glaucoma patients.
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