Sung Uk Baek1,2, Young Kook Kim3,4, Ki Ho Park3,4, Jin Wook Jeoung3,4. 1. Department of Ophthalmology, Hallym University College of Medicine. 2. Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang. 3. Department of Ophthalmology, Seoul National University College of Medicine. 4. Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Abstract
PURPOSE: The purpose of this study was to investigate the clinical outcomes of primary open-angle glaucoma (POAG) with an initial single-hemifield defect on visual field (VF) testing and the related risk factors for the involvement of the opposite hemifield during follow-up. METHODS: This longitudinal observational study included 108 POAG eyes of 108 patients who met the following conditions: (1) single-hemifield defect at initial VF examination; (2) follow-up >5 years. Eyes having undergone noncataract surgeries and laser treatment during the follow-up period were excluded. Patients were divided into group A (sparing of opposite hemifield) and group B (involvement of opposite hemifield) according to the patterns of VF progression. Baseline demographic and clinical characteristics were compared between the 2 groups. The Cox proportional hazards model was used to identify the risk factors for the involvement of the opposite hemifield. RESULTS: A total of 63 eyes (58.3%) were classified as group A and 45 (41.7%) as group B. The average follow-up period was 7.9 years. Between the 2 groups, significant differences were found in the age (55.7±10.7 vs. 61.0±10.5 y, P=0.015) and presence of optic disc vertical tilt (54.0% vs. 28.9%, P=0.034). According to the multivariate Cox proportional hazards model, older age (hazard ratio=1.704; P=0.025) and absence of optic disc vertical tilt (hazard ratio=1.430; P=0.017) were risk factors for the involvement of the opposite hemifield. CONCLUSIONS: In 108 POAG eyes with an initial single-hemifield defect, 41.7% showed involvement of the opposite hemifield during the average 8.0-year follow-up. Older age and absence of optic disc vertical tilt were significantly associated with a greater probability of involvement of the opposite hemifield.
PURPOSE: The purpose of this study was to investigate the clinical outcomes of primary open-angle glaucoma (POAG) with an initial single-hemifield defect on visual field (VF) testing and the related risk factors for the involvement of the opposite hemifield during follow-up. METHODS: This longitudinal observational study included 108 POAG eyes of 108 patients who met the following conditions: (1) single-hemifield defect at initial VF examination; (2) follow-up >5 years. Eyes having undergone noncataract surgeries and laser treatment during the follow-up period were excluded. Patients were divided into group A (sparing of opposite hemifield) and group B (involvement of opposite hemifield) according to the patterns of VF progression. Baseline demographic and clinical characteristics were compared between the 2 groups. The Cox proportional hazards model was used to identify the risk factors for the involvement of the opposite hemifield. RESULTS: A total of 63 eyes (58.3%) were classified as group A and 45 (41.7%) as group B. The average follow-up period was 7.9 years. Between the 2 groups, significant differences were found in the age (55.7±10.7 vs. 61.0±10.5 y, P=0.015) and presence of optic disc vertical tilt (54.0% vs. 28.9%, P=0.034). According to the multivariate Cox proportional hazards model, older age (hazard ratio=1.704; P=0.025) and absence of optic disc vertical tilt (hazard ratio=1.430; P=0.017) were risk factors for the involvement of the opposite hemifield. CONCLUSIONS: In 108 POAG eyes with an initial single-hemifield defect, 41.7% showed involvement of the opposite hemifield during the average 8.0-year follow-up. Older age and absence of optic disc vertical tilt were significantly associated with a greater probability of involvement of the opposite hemifield.