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Abstract #5646 Published in IGR 2-1
Fellow eye prognosis in patients with severe visual field loss in one eye from chronic open-angle glaucoma
Chen PP; Bhandari AArchives of Ophthalmology 2000; 118: 473-478
OBJECTIVES: To examine the prognosis for the fellow eye of patients with severe visual field loss in one eye from chronic forms of open-angle glaucoma, and to identify risk factors for visual field progression in such eyes. METHODS: Review of 36 patients followed in an academic medical center with monocular severe visual field loss (Advanced Glaucoma Intervention Study score > or =12) from open-angle glaucoma either at initial Humphrey visual field testing or during follow-up. Change in Advanced Glaucoma Intervention Study visual field score and clinical evaluation were used to determine visual field progression. Kaplan-Meier survival analysis and Cox proportional hazards survival regression were used to estimate visual field progression in fellow eyes and assess possible risk factors. RESULTS: During 67±32 months (mean ±SD), 12 of 36 first-affected eyes (33%) and six fellow eyes (17%) had significant visual field progression. The Kaplan-Meier estimate of visual field progression in the fellow eye was 12.4% at five years after severe visual field loss in the first eye. Compared with stable fellow eyes, fellow eyes with visual field progression had significantly larger initial cup/disc ratio, smaller between-eyes difference in the initial Advanced Glaucoma Intervention Study score, and lower calculated ocular perfusion pressure. Ocular perfusion pressure was the only variable significantly associated with visual field progression by Cox proportional hazards survival regression (p=0.019). During an average of 10.2 years of disease, two patients (6%) became bilaterally blind from glaucoma. CONCLUSIONS: In this predominantly white population, fellow eyes of patients with severe visual field loss in one eye from open-angle glaucoma were not at particularly high risk for further visual field progression, and few patients became bilaterally blind. Fellow eye visual field progression was associated with lower calculated ocular perfusion pressure.
Department of Ophthalmology, University of Washington School of Medicine, Seattle, WA 98195-6485, USA
Classification:
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)