Visual Field Outcomes from the Multicenter, Randomized Controlled Laser in Glaucoma and Ocular Hypertension Trial...

Area of Science:

• Ophthalmology
• Glaucoma Research
• Visual Field Analysis

Background:

• Ocular hypertension and glaucoma management strategies vary.
• Early treatment decisions impact long-term visual field outcomes.
• Selective laser trabeculoplasty (SLT) is an alternative to medical therapy.

Purpose of the Study:

• To compare visual field progression between ocular hypertensive and glaucoma patients initially treated with medical therapy versus SLT.
• To evaluate the efficacy of initial treatment choice on visual field preservation.

Main Methods:

• Secondary analysis of the multicenter Laser in Glaucoma and Ocular Hypertension study.
• Standard automated perimetry used to measure visual fields (VFs) over 48 months.
• Hierarchical linear models and log-binomial regression analyzed VF progression rates.

Main Results:

• A higher proportion of eyes receiving initial medical therapy showed moderate or fast total deviation (TD) progression compared to SLT (26.2% vs. 16.9%).
• Similar trends observed for pointwise TD progression rates.
• Pointwise pattern deviation (PD) progression was also higher in the medical therapy group, though overall PD progression did not differ significantly.

Conclusions:

• Initial medical therapy led to a slightly greater proportion of patients experiencing rapid visual field progression compared to initial SLT.
• SLT may be associated with better visual field outcome preservation in the initial management of ocular hypertension and glaucoma.