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Short-Term Rates of Visual Field Change Predict Glaucoma Progression
Mohsen Adelpour1, Sasan Moghimi1, Takashi Nishida1
1Viterbi Family Department of Ophthalmology, Shiley Eye Institute, Hamilton Glaucoma Center, University of California San Diego, La Jolla, California.
Ophthalmology. Glaucoma
|June 5, 2025
Summary
Short-term visual field mean deviation change predicts glaucoma progression. Faster initial rates of change indicate higher risk, aiding timely management and clinical trial endpoint selection.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Visual Field Analysis
Background:
- Glaucoma progression prediction is crucial for patient management.
- Short-term visual field (VF) mean deviation (MD) change may offer prognostic value.
- Understanding this relationship across glaucoma severities is important.
Purpose of the Study:
- To assess the prognostic significance of short-term VF MD change rates in predicting glaucoma progression.
- To evaluate this predictive ability across different glaucoma severity levels.
Main Methods:
- Observational cohort study of 349 eyes from 254 glaucoma patients over 5 years.
- Utilized Guided Progression Analysis (GPA) and FDA-consistent endpoints to define progression.
- Calculated initial 2-year VF MD change rates and employed survival models.
Main Results:
- Faster initial VF MD loss significantly increased progression risk (HR 1.16 for both GPA and FDA endpoints).
- Initial 2-year slopes showed high predictive accuracy, especially for FDA events (overall R²=0.75).
- Predictive accuracy was higher in early glaucoma (R²=0.71) than moderate-to-advanced stages (R²=0.42).
Conclusions:
- Initial 2-year VF MD change rate effectively predicts subsequent glaucoma progression using FDA-consistent criteria.
- Identifies high-risk patients for timely intervention and potential clinical trial endpoints.
- Supports the use of short-term VF MD change as a prognostic marker in glaucoma.
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