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Abstract #6456 Published in IGR 3-2
Rate of visual field loss and long-term visual outcome in primary open-angle glaucoma
Kwon YH; Kim CS; Zimmerman MB; Alward WLM; Hayreh SSAmerican Journal of Ophthalmology 2001; 132: 47-56
PURPOSE: To evaluate long-term visual field outcome in primary open-angle glaucoma (POAG). METHODS: In this retrospective cohort study, 40 eyes of 40 patients with POAG with elevated intraocular pressure (IOP) and a minimum of eight-year longitudinal series of visual fields, were plotted with the Goldmann perimeter. Eyes with any other ocular disease except cataract were excluded. Manual grid templates were used to quantify the visual fields. Linear regression was performed to estimate the rate of visual field decline. Pertinent clinical factors were evaluated for statistical association with the rate of decline. Long-term clinical outcome including visual acuity, rate of legal blindness, and rate of medical and surgical interventions, was also measured. RESULTS: In the 40 eyes studied, with a mean follow-up of 14 years, the visual field score decreased at the rate of -1.5% per year. Overall, 68% showed significant decrease, and the rate of decrease among these eyes was -2.1% per year. Five eyes became legally blind from glaucoma; the cumulative rate of blindness from glaucoma was 19% at 22 years. Higher IOP and greater number of antiglaucoma medications on initial presentation were associated with faster and slower deterioration of visual field (compared with the average), respectively. CONCLUSIONS: With standard glaucoma therapy, the rate of visual field loss in POAG is slow. Lower IOP and more antiglaucoma medications are associated with slower visual field decline. Legal blindness from glaucoma was 19% over a follow-up of 22 years.
Dr Y.H. Kwon, Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA. young-kwon@uiowa.edu
Classification:
11 Medical treatment
12 Surgical treatment
