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Abstract #57034 Published in IGR 16-2
Visual field improvement in the collaborative initial glaucoma treatment study
Musch DC; Gillespie BW; Palmberg PF; Spaeth G; Niziol LM; Lichter PRAmerican Journal of Ophthalmology 2014; 158: 96-104.e2
See also comment(s) by Kouros Nouri-Mahdavi •
PURPOSE: To evaluate critically visual field (VF) improvement in participants in the Collaborative Initial Glaucoma Treatment Study (CIGTS). DESIGN: Prospective, comparative case series from a randomized clinical trial comparing trabeculectomy and topical medications in treating open-angle glaucoma (OAG). METHODS: A total of 607 subjects with newly diagnosed OAG were identified for study. Baseline and follow-up VF tests were obtained and mean deviation (MD) change from baseline over follow-up was analyzed. Clinically substantial change (loss or improvement) was defined as change from baseline of ≥ 3 decibels in MD. Baseline factors were inspected to determine their association with VF improvement in repeated measures regression models. RESULTS: The percentage of participants showing substantial VF improvement over time was similar to that showing VF loss through 5 years after initial treatment, after which VF loss became more frequent. Measures of better intraocular pressure (IOP) control during treatment were significantly predictive of VF improvement, including a lower mean IOP, a lower minimum IOP, and lower sustained levels of IOP over follow-up. Other predictive factors included female sex (odds ratio [OR] = 1.73), visits 1 year prior to cataract extraction (OR = 0.11), and an interaction between treatment and baseline MD wherein surgically treated subjects with worse baseline VF loss were more likely to show VF improvement. CONCLUSIONS: In the CIGTS, substantial VF loss and improvement were comparable through 5 years of follow-up, after which VF loss became more frequent. Predictive factors for VF improvement included several indicators of better IOP control, which supports the postulate that VF improvement was real.
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Classification:
13.2.2.2 Improvement (Part of: 13 Therapeutic prognosis and outcome > 13.2 Outcome > 13.2.2 Visual field)