advertisement
Abstract #81336 Published in IGR 20-3
Risk Factors For Fast Visual Field Progression In Glaucoma
Kim JH; Rabiolo A; Morales E; Yu F; Afifi AA; Nouri-Mahdavi K; Caprioli JAmerican Journal of Ophthalmology 2019; 207: 268-278
PURPOSE: To identify baseline and longitudinal risk factors for fast visual field decay in open angle glaucoma patients. DESIGN: Retrospective cohort study. METHODS: Open-angle glaucoma patients with ≥6 visual fields (VF) and ≥4 years of follow-up were included. Visual field decay rates were measured with the following methods: mean deviation (MD) rate, visual field index (VFI) rate, and the Glaucoma Rate Index (GRI). The relationship between visual field 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: 1,317 eyes of 745 patients with a mean (± SD) age of 63.3 (±10.9) years and a median (IQR) MD -2.4 (-0.7 to -5.6) dB at baseline were analyzed. The median (IQR) number of VFs was 12 (9 to 16), and mean follow-up duration was 11.5 (±3.7) years. Older age (p<0.001), higher peak IOP (p<0.001), pseudoexfoliative glaucoma (p<0.05), and glaucoma surgery during the study period (p<0.001) were associated with faster rates of progression regardless of the method used. Worse baseline MD was associated with MD rate (p=0.02), but neither with VFI rate (p=0.37) nor GRI (p=0.31). Higher peak IOP (p=0.005) were significant predictors 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.
Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA; Siloam Eye Hospital, Seoul, Korea.
Full articleClassification:
6.20 Progression (Part of: 6 Clinical examination methods)
9.4.4.1 Exfoliation syndrome (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders > 9.4.4 Glaucomas associated with disorders of the lens)
9.2.2 Other risk factors for glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
