Ji Hyun Kim1, Alessandro Rabiolo2, Esteban Morales3, Fei Yu4, Abdelmonem A Afifi5, Kouros Nouri-Mahdavi3, Joseph Caprioli6. 1. Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Siloam Eye Hospital, Seoul, Korea. 2. Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Department of Ophthalmology, University Vita-Salute, IRCCS San Raffaele, Milan, Italy. 3. Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA. 4. Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA. 5. Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA. 6. Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA. Electronic address: caprioli@jsei.ucla.edu.
Abstract
PURPOSE: To identify baseline and longitudinal risk factors for fast visual field (VF) decay in patients with open-angle glaucoma. DESIGN: Retrospective cohort study. METHODS: Patients with open-angle glaucoma with ≥6 VFs and ≥4 years of follow-up were included. VF decay rates were measured with the following methods: mean deviation (MD) rate, VF index (VFI) rate, and the Glaucoma Rate Index (GRI). The relationship between VF rates and clinical variables were investigated with linear mixed models. Logistic regression analysis was performed to determine which factors were associated with fast progression. RESULTS: A total of 1317 eyes of 745 patients with a mean (± SD) age of 63.3 (±10.9) years and a median (interquartile range) MD -2.4 (-0.7 to -5.6) dB at baseline were analyzed. The median (interquartile range) number of VFs was 12 (9 to 16), and mean follow-up duration was 11.5 (±3.7) years. Older age (P < .001), higher peak intraocular pressure (IOP) (P < .001), and glaucoma surgery during the study period (P < .001) were associated with faster rates of progression regardless of the method used. Worse baseline MD was associated with MD rate (P = .02), but neither with VFI rate (P = .37) nor GRI (P = .31); whereas pseudoexfoliative glaucoma was associated with faster rates of progression with MD (P = .008) and VFI (P = .01) rates, but not with GRI. Higher peak IOPs (P = .005) was a significant predictor for fast progression. CONCLUSION: In this cohort, older age, peak IOP, pseudoexfoliative glaucoma, and baseline MD were associated with the rate of glaucomatous VF worsening. Fast progressors had a higher peak IOP than non-fast progressors. The identification and appropriately aggressive treatment of fast progressors would reduce visual disability from glaucoma.
PURPOSE: To identify baseline and longitudinal risk factors for fast visual field (VF) decay in patients with open-angle glaucoma. DESIGN: Retrospective cohort study. METHODS:Patients with open-angle glaucoma with ≥6 VFs and ≥4 years of follow-up were included. VF decay rates were measured with the following methods: mean deviation (MD) rate, VF index (VFI) rate, and the Glaucoma Rate Index (GRI). The relationship between VF rates and clinical variables were investigated with linear mixed models. Logistic regression analysis was performed to determine which factors were associated with fast progression. RESULTS: A total of 1317 eyes of 745 patients with a mean (± SD) age of 63.3 (±10.9) years and a median (interquartile range) MD -2.4 (-0.7 to -5.6) dB at baseline were analyzed. The median (interquartile range) number of VFs was 12 (9 to 16), and mean follow-up duration was 11.5 (±3.7) years. Older age (P < .001), higher peak intraocular pressure (IOP) (P < .001), and glaucoma surgery during the study period (P < .001) were associated with faster rates of progression regardless of the method used. Worse baseline MD was associated with MD rate (P = .02), but neither with VFI rate (P = .37) nor GRI (P = .31); whereas pseudoexfoliative glaucoma was associated with faster rates of progression with MD (P = .008) and VFI (P = .01) rates, but not with GRI. Higher peak IOPs (P = .005) was a significant predictor for fast progression. CONCLUSION: In this cohort, older age, peak IOP, pseudoexfoliative glaucoma, and baseline MD were associated with the rate of glaucomatous VF worsening. Fast progressors had a higher peak IOP than non-fast progressors. The identification and appropriately aggressive treatment of fast progressors would reduce visual disability from glaucoma.
Authors: Daniel C Terveen; Steven R Sarkisian; Steven D Vold; Deepan Selvadurai; Blake K Williamson; Deborah G Ristvedt; Adam R Bleeker; Kavita Dhamdhere; Jaime E Dickerson Journal: Int Ophthalmol Date: 2022-10-13 Impact factor: 2.029
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