Association Between Longitudinal 10-2 Central Visual Field Change and the Risk of Visual Acuity Loss in Mild-to-Moderate Glaucoma

Author:

Wu Jo-Hsuan1,Moghimi Sasan1,Nishida Takashi1,Kamalipour Alireza1,Liebmann Jeffrey M.2,Fazio Massimo3,Girkin Christopher A.3,Zangwill Linda M.1,Weinreb Robert N.1

Affiliation:

1. Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, Shiley Eye Institute, University of California, San Diego, La Jolla, CA

2. Department of Ophthalmology, Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY

3. Department of Ophthalmology and Vision Sciences, Heersink School of Medicine, University of Alabama-Birmingham, Birmingham, UK

Abstract

Précis: Faster worsening of 10-2 visual field (VF) was associated with the development of visual acuity (VA) loss in mild-to-moderate glaucoma, suggesting longitudinal 10-2 VF change is associated with the risk of VA impairment. Purpose: To examine whether longitudinal 10-2 central VF change is associated with the risk of VA loss in glaucoma. Patients and Methods: Primary open angle glaucoma and glaucoma suspect eyes with ≥3 years and 5 visits of 10-2 VF examinations were included. Cox proportional hazard modeling with shared frailty was used to evaluate the hazard ratio (HR) of 10-2 VF mean deviation (MD), superior hemifield mean sensitivity (hemi-MS), and inferior hemi-MS worsening rates for developing VA loss, defined as a change in logMAR VA ≥95% test-retest variability. Results: Among the 252 eyes (148 participants, mean follow-up = 5.8 y), 30 eyes (21 participants, mean follow-up = 4.9 y) developed VA loss. There was no difference in baseline VF between eyes with and without VA loss (P > 0.05). Eyes with VA loss showed faster 10-2 VF MD worsening [−0.39 (95% CI: −0.60, −0.18) dB/y] and hemi-MS decrease (range: −0.42~−0.38 dB/y), as compared with no-VA loss eyes [10-2 VF MD change = −0.11 (−0.16, −0.07) dB/y; hemi-MS change: −0.12~−0.07 dB/y; P < 0.05]. In the multivariable model, faster 10-2 VF MD worsening [HR (95% CI) = 4.05 (1.61, 10.22), per 1 dB/y faster], superior hemi-MS decrease [HR (95% CI) = 7.07 (2.48, 20.14), per 1 dB/y faster], and inferior hemi-MS decrease [HR (95% CI) = 8.32 (1.99, 34.91), per 1 dB/y faster] were all associated with increased risk of developing VA loss (P < 0.05). Conclusions: Faster 10-2 VF MD and hemifield MS worsening are associated with the development of VA loss. Monitoring the longitudinal central 10-degree VF change may suggest that there is impending VA impairment in glaucoma.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Ophthalmology

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