The primary treatment trial: changes in the visual field analysis by computer-assisted perimetry

Area of Science:

• Ophthalmology
• Clinical Research
• Glaucoma Management

Background:

• Glaucoma treatment aims to prevent vision loss.
• Surgical, medical, and laser interventions are primary treatment options.
• Assessing long-term visual field progression is crucial for evaluating treatment efficacy.

Purpose of the Study:

• To compare the rate of visual field change in patients with glaucoma undergoing surgery versus medical management.
• To investigate if differences in intraocular pressure correlate with visual field progression across treatment groups.

Main Methods:

• Computer-assisted perimetry (30-2 program) was conducted every six months.
• Pointwise linear regression analysis (Progressor) was applied to patients with at least five visual fields.
• Progression was defined as two consecutive slopes significant at the 0.05 level.

Main Results:

• Forty-eight patients in the surgery group, 40 in the medical group, and 20 in the laser group were analyzed.
• No significant difference in visual field improvement or worsening was observed between the surgery and medical groups.
• This lack of difference persisted despite a statistically significant difference in intraocular pressure between these two groups.

Conclusions:

• Current glaucoma treatments (surgery vs. medical) show comparable long-term visual field outcomes.
• Intraocular pressure differences alone may not fully explain visual field progression rates across different treatment modalities.
• Further research is needed to understand the multifactorial nature of glaucoma progression and optimize treatment strategies.