Visual field prognosis in early glaucoma. A long-term clinical follow-up.

Fifty-four eyes of 45 patients with ocular hypertension developed early glaucomatous optic disc or visual field changes after a mean follow-up of 5.1 years without therapy. These changes initiated antiglaucomatous treatment, and the eyes have been followed further on therapy for 2-14 years (mean 8.0 years) in a retrospective study. The mean intraocular pressure (IOP) was lowered from 28.9 to 19.3 mmHg. Half of the eyes were still without field defects at the end of the study, whereas 7 eyes developed extensive field damage noticeable to the patients. The eyes with deteriorating visual fields could not be differentiated from the stable ones by means of the pre-therapy IOP, nor the mean or peak IOP on treatment. There was an accumulation of topical and general risk factors in the progressive eyes. The results support the importance of taking other risk factors than the IOP into consideration in the management of our glaucoma patients.