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Abstract #49240 Published in IGR 14-1
Rates of visual field progression in distinct optic disc phenotypes
Schor KS; De Moraes CG; Teng CC; Tello C; Liebmann JM; Ritch RClinical and Experimental Ophthalmology 2012; 40: 706-712
BACKGROUND: To determine if optic disc phenotype is correlated with the rate of glaucomatous visual field (VF) progression. DESIGN: Retrospective cohort. PARTICIPANTS OR SAMPLES: Treated glaucoma patients with ≥8 VF tests. METHODS: The optic disc stereophotographs of glaucoma patients were reviewed by two investigators masked to all clinical and perimetric data. Each disc was classified as focal ischemic, myopic, senile sclerotic, and generalized enlargement. VF progression (defined as at least two adjacent test points in the same hemifield progressing by more than 1.0 dB/yr at p < 0.01) was evaluated using automated pointwise linear regression. Main outcome measures: Association between optic disc phenotypes and other clinical variables and rates of VF progression. RESULTS: 264 optic disc stereophotographs (127 generalized enlargement, 41 focal ischemic, 54 myopic, and 42 senile sclerotic) were evaluated. In the univariate analyses, we found that patients with senile sclerotic discs were older (p = 0.002) and those with generalized enlargement had better baseline visual field MD (p < 0.001) and higher IOP (p = 0.006) compared to the other groups. More disc hemorrhages were detected in the focal ischemic and senile sclerotic groups (p = 0.010). After adjusting for other risk factors (IOP, age, CCT, disc hemorrhage), there were no differences among groups regarding the risk (p = 0.58) and velocity (p = 0.21) of VF progression. CONCLUSIONS: VF progression was similar among the four optic disc phenotypes in treated glaucoma after adjusting for other known risk factors. The division of disc appearance into clinical phenotypes does not appear to provide independent information regarding the risk of progression in clinical practice.
Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY, USA.
Full articleClassification:
6.20 Progression (Part of: 6 Clinical examination methods)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
