Factors associated with visual field or structure progression occurring first in a prospective study on patients with untreated open-angle glaucoma with normal intraocular pressure
Author:
Sakata ReiORCID, Araie Makoto, Yoshitomi Takeshi, Yoshitomi Takeshi, Ishikawa Makoto, Abe Haruki, Fukuchi Takeo, Sugiyama Kazuhisa, Ohkubo Shinji, Nitta Koji, Araie Makoto, Tomidokoro Atsuo, Hirasawa Hiroyo, Yoshikawa Keiji, Iwase Aiko, Negi Akira, Yamada Yuko, Tanihara Hidenobu, Inatani Masaru, Inoue Toshihiro, Takihara Yuji, Ohhira Saori, Kojima Sachi, Naitou Chika, Shirakashi Motohiro, Higashide Tomomi, Matsumoto Chota, Takada Sonoko, Aihara Makoto, Saito Hitomi,
Abstract
Abstract
Background/Objectives
To identify factors associated with disc/retina deterioration in stereo fundus photographs preceding that of the visual field (VF), as determined with a Humphrey Field Analyzer (HFA) (Structure First deterioration) and factors associated with the latter preceding the former (Field First deterioration) in open-angle glaucoma (OAG) with lower normal intraocular pressure (IOP).
Subjects/Methods
Prospective cohort study. Ninety eyes of 90 patients with OAG and a baseline IOP < 15 mmHg participated in a 5-year prospective study without treatment. IOP measurements and HFA 24-2 Swedish Interactive Test Algorithm Standard tests were performed every 3 months, and fundus photographs were obtained every 6 months. VF deterioration was determined by Guided Progression Analysis and deterioration of disc/retina was determined on stereophotographs by an independent committee. A multivariable Cox proportional hazard model was used to identify factors associated with Structure First deterioration, and with Field First deterioration.
Results
The average baseline age and mean deviation were 53.9 ± 9.8 years and −2.8 ± 2.8 dB, respectively. During the 5-year follow-up, the probability of Field First deterioration was 49% ± 6.6% (standard error) and that of Structure First deterioration was 33% ± 6.4% (P = 0.062, log-rank test). Disc hemorrhage (DH) prior to the event (P = 0.006) was associated with Structure First deterioration, and older age was associated with Field First deterioration (P = 0.040).
Conclusions
In OAG eyes with lower normal IOP, DH was significantly associated with Structure First deterioration, and age was significantly associated with Field First deterioration.
Funder
Ministry of Education, Culture, Sports, Science and Technology
Publisher
Springer Science and Business Media LLC
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