advertisement
Abstract #6425 Published in IGR 3-2
Risk factors for progression of visual field abnormalities in normal-tension glaucoma
Drance S; Anderson DR; Schulzer MAmerican Journal of Ophthalmology 2001; 131: 699-708
PURPOSE: To uncover risk factors for the highly variable individual rates of progression in cases of untreated normal-tension glaucoma (NTG). METHODS: Visual field data were assembled from 160 subjects (160 eyes) enrolled in the collaborative NTG study during intervals in which the eye under study was not receiving intraocular pressure (IOP)-lowering treatment during pre-randomization and post-randomization intervals. Analyses included multivariate analysis of time-dependent Cox proportional hazard, Kaplan-Meier analysis of 'survival' without an increment of visual field worsening, and comparison of slopes of change in mean deviation global index over time. RESULTS: Most migraine occurred in women, but analysis demonstrated that gender and presence of migraine contribute separately to the overall risk. The risk ratio for migraine, adjusted for the other variables was 2.58 (p = 0.0058), for disc hemorrhage 2.72 (p = 0.0036), and for female gender 1.85 (p = 0.0622). The average fall in the mean deviation index was faster in nonmigrainous women than in nonmigrainous men (p = 0.05). Suggesting genetic influence, Asians had a slower rate of progression (p = 0.005), and the few black patients enrolled had a tendency for faster progression. However, self-declared history of family with glaucoma or treated for glaucoma did not affect the rate of progression. Neither age nor the untreated level of IOP affected the rate of untreated disease progression, despite their known influence on prevalence. CONCLUSIONS: While risk factors for prevalence help select populations within which to screen for glaucoma, the factors that affect the rate of progression help decide the expected prognosis of the individual's untreated disease, and thereby the frequency of follow-up and aggressiveness of the therapy to be undertaken.
Dr D.R. Anderson, Bascom Palmer Eye Institute, 900 NW 17th Street, PO Box 016880, Miami, FL 33101, USA
Classification:
9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
