Preperimetric glaucoma: conversion to primary open-angle glaucoma in a 10-year follow-up

Area of Science:

• Ophthalmology
• Glaucoma Research
• Clinical Ophthalmology

Background:

• Preperimetric open-angle glaucoma (PPG) represents an early stage of glaucoma.
• Long-term clinical course and conversion rates to primary open-angle glaucoma (POAG) require further investigation.
• Identifying prognostic factors for PPG progression is crucial for patient management.

Purpose of the Study:

• To determine the long-term clinical course of PPG over more than 10 years.
• To identify specific factors associated with the conversion of PPG to POAG.
• To evaluate the prognostic significance of optic disc hemorrhage (DH) and intraocular pressure (IOP) reduction.

Main Methods:

• Longitudinal study including 124 eyes from 124 PPG patients followed for over 10 years.
• Progression defined by structural or functional deterioration; analyzed using Cox proportional hazard modeling.
• Kaplan-Meier survival analysis compared progression probability in patients with and without disc hemorrhage (DH).

Main Results:

• 35.5% of PPG patients converted to POAG within a mean follow-up of 12.2 years.
• Significant predictors of glaucoma progression included migraine/headache, insufficient intraocular pressure (IOP) reduction, and disc hemorrhage (DH).
• Patients with DH showed a significantly higher cumulative probability of progression (p=0.017).

Conclusions:

• A substantial proportion of PPG patients convert to POAG, necessitating long-term monitoring.
• Insufficient IOP reduction and the presence of DH are key indicators of increased progression risk in PPG.
• DH holds significant prognostic value in predicting glaucoma progression in PPG patients.