Risk Factors and Frequency of Examinations for Detecting Visual Field Deterioration in Patients Newly Diagnosed Exfoliation Glaucoma in Sweden

Abstract

Précis: The study identified risk factors for exfoliation glaucoma and recommended reevaluating target IOP after five visual fields to slow disease progression. Purpose: This study aimed to establish risk factors for exfoliation glaucoma and determine the earliest time points for estimating disease progression. Patients: A total of 96 patients with newly diagnosed exfoliation glaucoma were included. Included patients were required to perform at least seven visual field tests within a three-year period (± three months). All patients were treated at inclusion. Methods: This was a non-randomized, prospective cohort study. The predictors measured included intraocular pressure (IOP), mean deviation (MD), and visual field index (VFI). Progression was assessed using the rate of progression (ROP) based on MD, VFI, and “Guided Progression Analysis” (GPA). Linear or logistic regression models were developed based on the variables studied. An analysis of variance (ANOVA) was used to establish the earliest time point. At the earliest time point, the models were re-tested. The area under the receiver operating characteristic (ROC) curve (AUC) was calculated. Results: The general rate of progression of the cohort was −3.84 (±2.61) dB for the MD values and 9.66 (±6.25) % for the VFI values over three years. The IOP, MD, and VFI values at diagnosis were predictors of progression for both linear and logistic regression. ANOVA and post-hoc Tukey’s test showed significant values at 24 months for MD and VFI. The AUC at 24 months showed significant values for MD and VFI. Conclusions: The predictors studied (IOP, MD, and VFI) showed moderate accuracy at baseline but excellent predictive capacity at 24 months post-diagnosis. Re-evaluating the target IOP at 24 months can effectively slow down disease progression.