Visual Field Progression in Glaucoma Patients With Delayed Follow-Up

Area of Science:

• Ophthalmology
• Glaucoma Research
• Clinical Practice Guidelines

Background:

• Glaucoma management relies on regular monitoring to prevent vision loss.
• Current follow-up intervals are provider-dependent and may not be optimized.
• Understanding the impact of delayed follow-up (DFU) on glaucoma progression is crucial.

Purpose of the Study:

• To investigate the association between delayed follow-up (DFU) and glaucoma progression.
• To evaluate current glaucoma follow-up practices and their impact on disease outcomes.

Main Methods:

• Retrospective cohort and matched case-control study of 600 glaucoma patients.
• Analysis of Humphrey Visual Field (HVF) data and electronic health records from 2014-2023.
• Quantified DFU metrics and analyzed associations with HVF progression using multivariable logistic regression.

Main Results:

• No significant association found between DFU metrics and HVF progression in multivariable analyses.
• Older age, larger cup-to-disc ratio, and unmet social needs were associated with increased progression risk.
• In a matched case-control analysis, mean DFU >60 days was associated with higher odds of progression in patients with baseline MD < -6 dB.

Conclusions:

• Current glaucoma follow-up intervals may be longer than necessary for many patients.
• DFU was not a significant predictor of progression for the general glaucoma population.
• Tailored follow-up strategies considering disease severity and individual risk factors may be warranted.