Literature DB >> 22525124

The impact of surgical intraocular pressure reduction on visual function using various criteria to define visual field progression.

Namita Bhardwaj1, Philip I Niles, David S Greenfield, Maggie Hymowitz, Mitra Sehi, William J Feuer, Donald L Budenz.   

Abstract

PURPOSE: To examine the impact of surgical intraocular pressure (IOP) reduction on visual function using various methods to define visual field (VF) progression.
METHODS: A retrospective chart review was conducted on consecutive glaucoma patients who underwent surgical IOP reduction between January 1, 2002 and December 31, 2007. All subjects had glaucomatous optic neuropathy, a minimum of 5 preoperative and 5 postoperative VFs, and were followed for a minimum of 2 years both before and after surgery. VF progression was determined using guided progression analysis, linear regression analysis of the visual field index, and individual sensitivity values using Progressor software.
RESULTS: Seventeen eyes of 17 patients (mean age 77.9±9.9 y) were enrolled. Subjects were followed for a mean 5.8±2.4 years before surgery and 4.5±1.5 years after surgery. The mean postoperative IOP (11.3±4.2 mm Hg) and medications (1.3±1.3) were significantly (P<0.001 and P=0.01) reduced compared with before surgery (18.0±3.9 mm Hg, 2.4±0.9, respectively). The number of eyes judged to have VF progression using any method during the postoperative period (3 of 17, 17.6%) was significantly (P=0.03) reduced compared with the preoperative period (9 of 17 eyes, 52.9%). Using visual field index criteria, 8 eyes were judged to have preoperative VF progression and 1 eye had persistent VF progression during the postoperative period. None of the eyes judged to have preoperative VF progression using Early Manifest Glaucoma Trial (n=4) and Progressor criteria (n=1) demonstrated persistent VF progression during the postoperative period. Among eyes with preoperative VF progression, the postoperative slope of mean deviation (-0.21±0.23 dB/y) was significantly (P=0.03) reduced compared with before surgery (-1.01±0.23 dB/y).
CONCLUSIONS: Despite differences in the criteria used to define VF progression, glaucoma surgical IOP reduction significantly reduces the incidence and rate of VF progression.

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Year:  2013        PMID: 22525124      PMCID: PMC3423498          DOI: 10.1097/IJG.0b013e3182567cfc

Source DB:  PubMed          Journal:  J Glaucoma        ISSN: 1057-0829            Impact factor:   2.503


  26 in total

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2.  Pointwise topographical and longitudinal modeling of the visual field in glaucoma.

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5.  Pointwise univariate linear regression of perimetric sensitivity against follow-up time in glaucoma.

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6.  Comparison of glaucomatous progression between untreated patients with normal-tension glaucoma and patients with therapeutically reduced intraocular pressures. The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma.

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8.  Patterns of glaucomatous visual field progression identified by three progression criteria.

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9.  Comparison of different methods for detecting glaucomatous visual field progression.

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10.  Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial.

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3.  Central 10-degree visual field change following non-penetrating deep sclerectomy in severe and end-stage glaucoma: preliminary results.

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4.  Effects of glaucoma surgery on visual field progression in open-angle glaucoma considering the floor effect.

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