scholarly journals Long-Term Clinical Course of Normal-Tension Glaucoma: 20 Years of Experience

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Sang Wook Jin ◽  
Seung Yoon Noh
Keyword(s):  
Visual Field ◽  
Clinical Course ◽  
Visual Fields ◽  
Reduction Rate ◽  
Normal Tension Glaucoma ◽  
Mean Deviation ◽  
Progression Rate ◽  
Visual Field Progression ◽  
The Mean

Purpose. The purpose of this study was to investigate the long-term clinical course of NTG patients who initiated intraocular pressure- (IOP-) lowering therapy.Methods. The present study included 72 normal-tension glaucoma (NTG) patients. The mean deviation (MD) was measured with visual fields. Nocturnal hypotension with weighted standard deviation (wSD) was determined by 24-hour ambulatory blood pressure monitoring. To identify risk factors for NTG progression, linear logistic regression analysis was employed.Results. The mean follow-up period was 21.2 ± 1.1 years. The mean MD progression rate was −0.28 ± 0.24 dB/year. The mean ocular perfusion pressure (OPP) was 52.1 ± 5.9 mmHg. The mean wSD was 14.5 ± 2.2. In the univariate model, disc hemorrhage (RR 7.12;P=0.004), IOP reduction rate (RR 2.12;P=0.045), and OPP (RR 1.94;P=0.027) were associated with glaucomatous visual field progression. However, in the multivariate model, the IOP reduction rate (RR 2.45;P=0.048) and OPP (RR 2.02;P=0.004) were detected to be significant factors associated with progression.Conclusions. The mean rate of visual field progression was −0.28 dB/year in NTG patients treated with medical therapy. The IOP reduction rate and OPP were associated with glaucomatous visual field progression.

scholarly journals Retrobulbar Hemodynamics and Visual Field Progression in Normal Tension Glaucoma: A Long-Term Follow-Up Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
D. Kuerten ◽  
M. Fuest ◽  
E. C. Koch ◽  
A. Koutsonas ◽  
N. Plange
Keyword(s):  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Doppler Imaging ◽  
Progression Rate ◽  
Visual Field Progression ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
Retrobulbar Hemodynamics

Purpose. Vascular risk factors are important factors in the pathogenesis of glaucoma. The purpose of this research was to investigate retrobulbar hemodynamics and visual field progression in patients with normal tension glaucoma (NTG).Patients and Methods. 31 eyes of 16 patients with NTG were included in a retrospective long-term follow-up study. Colour Doppler imaging was performed at baseline to determine various CDI parameters in the different retrobulbar vessels. The rate of visual field progression was determined using the Visual Field Index (VFI) progression rate per year (in %). To be included in the analysis, patients had at least 4 visual field examinations with a follow-up of at least 2 years.Results. Mean follow-up was 7.6 ± 4.1 years with an average of 10 ± 5 visual field tests. The mean MD (mean defect) at baseline was −7.61 ± 7.49 dB. The overall VFI progression was −1.14 ± 1.40% per year. A statistical significant correlation between VFI progression and the RI of the NPCA and PSV of the CRA was found.Conclusion. Long-term visual field progression may be linked to impaired retrobulbar hemodynamics in patients with NTG only to a limited degree. Interpretation of the data for an individual patient seems to be limited due to the variability of parameters.

Role of Central Corneal Thickness on Baseline Parameters and Progression of Visual Fields in Open Angle Glaucoma

2007 ◽  
Vol 17 (4) ◽  
pp. 545-549 ◽  
Author(s):  
H. Shah ◽  
C. Kniestedt ◽  
A. Bostrom ◽  
R. Stamper ◽  
S. Lin
Keyword(s):  
Visual Field ◽  
Central Corneal Thickness ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Visual Fields ◽  
Negative Relationship ◽  
Significant Risk ◽  
Mean Deviation ◽  
Open Angle ◽  
Visual Field Progression

Purpose To evaluate the relationship of central corneal thickness (CCT) to baseline visual field parameters and visual field progression in patients with primary open-angle glaucoma (POAG). Methods Charts of consecutive patients with POAG were reviewed to obtain visual field data. Visual field was measured by standard threshold static perimetry. Variables analyzed included mean deviation (MD) and pattern standard deviation (PSD). Results A total of 121 eyes examined over 4 years were evaluated. A significant negative relationship between CCT and PSD (correlation coefficient: −0.02, p<0.05) was found. Analyses comparing CCT to change in PSD and MD (visual field progression) were statistically not significant. Conclusions Patients with thinner corneas initially present with a greater visual field defect, indicating that thin corneas may contribute to advanced glaucomatous damage at the time of diagnosis. However, CCT does not seem to be a significant risk factor for progression of the disease.

scholarly journals Classification and Statistical Trend Analysis in Detecting Glaucomatous Visual Field Progression

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Cristiana Valente ◽  
Elisa D’Alessandro ◽  
Michele Iester
Keyword(s):  
Statistical Analysis ◽  
Standard Deviation ◽  
Visual Field ◽  
Trend Analysis ◽  
Open Angle Glaucoma ◽  
Mean Deviation ◽  
Threshold Strategy ◽  
Visual Field Progression ◽  
The Mean

Aim. To evaluate the agreement between different methods in detection of glaucomatous visual field progression using two classification-based methods and four statistical approaches based on trend analysis. Methods. This is a retrospective and longitudinal study. Twenty Caucasian patients (mean age 73.8 ± 13.43 years) with open-angle glaucoma were recruited in the study. Each visual field was assessed by Humphrey Field Analyzer, program SITA standard 30-2 or 24-2 (Carl Zeiss Meditec, Inc., Dublin, CA). Full threshold strategy was also accepted for baseline tests. Progression was analyzed by using Hodapp–Parrish–Anderson classification and the Advanced Glaucoma Intervention Study visual field defect score. For the statistical analysis, linear regression (r2) was calculated for mean deviation (MD), pattern standard deviation (PSD), and visual field index (VFI), and when it was significant, each series of visual field was considered progressive. We also used Progressor to look for a significant progression of each visual field series. The agreement between methods, based on statistical analysis and classification, was evaluated using a weighted kappa statistic. Results. Thirty-eight visual field series were analyzed. The mean follow-up time was 6.2 ± 1.53 years (mean ± standard deviation). At baseline, the mean MD was −7.34 ± 7.18 dB; at the end of the follow-up, the mean MD was −9.25 ± 8.65 dB; this difference was statistically significant (p<0.001). The agreement to detect progression was fair between all methods based on statistical analysis and classification except for PSD r2. A substantial agreement (κ = 0.698 ± 0.126) was found between MD r2 and VFI r2. With the use of all the statistical analysis, there was a better time-saving. Conclusions. The best agreement to detect progression was found between MD r2 and VFI r2. VFI r2 showed the best agreement with all the other methods. GPA2 can help ophthalmologists to detect glaucoma progression and to help in treatment decisions. PSD r2 was the worse method to detect progression.

Optical Coherent Tomography Predicts Long-Term Visual Outcome of Pituitary Adenoma Surgery: New Perspectives From a 5-Year Follow-up Study

Neurosurgery ◽  
2020 ◽  
Vol 88 (1) ◽  
pp. 106-112 ◽  
Author(s):  
Young Soo Chung ◽  
Minkyun Na ◽  
Jihwan Yoo ◽  
Woohyun Kim ◽  
In-Ho Jung ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Visual Field ◽  
Assessment Tool ◽  
Visual Fields ◽  
Visual Field Defects ◽  
Mean Deviation ◽  
Rnfl Thickness ◽  
Long Term Follow Up

Abstract BACKGROUND Compressive optic neuropathy is the most common indication for transsphenoidal surgery for pituitary adenomas. Optical coherence tomography (OCT) is a useful visual assessment tool for predicting postoperative visual field recovery. OBJECTIVE To analyze visual parameters and their association based on long-term follow-up. METHODS Only pituitary adenoma patients with abnormal visual field defects were selected. A total of 188 eyes from 113 patients assessed by visual field index (VFI) and 262 eyes from 155 patients assessed by mean deviation (MD) were enrolled in this study. Postoperative VFI, MD, and retinal nerve fiber layer (RNFL) thickness were evaluated and followed up. After classifying the patients into normal (&gt;5%) and thin (&lt;5%) RNFL groups, we investigated whether preoperative RNFL could predict visual field outcomes. We also observed how RNFL changes after surgery on a long-term basis. RESULTS Both preoperative VFI and MD had a linear proportional relationship with preoperative RNFL thickness. Sustained improvement of the visual field was observed after surgery in both groups, and the degree of improvement over time in each group was similar. RNFL thickness continued to decrease until 36 mo after surgery (80.2 ± 13.3 μm to 66.6 ± 11.9 μm) while visual field continued to improve (VFI, 61.8 ± 24.5 to 84.3 ± 15.4; MD, −12.9 ± 7.3 dB to −6.3 ± 5.9 dB). CONCLUSION Patients with thin preoperative RNFL may experience visual recovery similar to those with normal preoperative RNFL; however, the probability of normalized visual fields was not comparable. RNFL thickness showed a strong correlation with preoperative visual field defect. Long-term follow-up observation revealed a discrepancy between anatomic and functional recovery.

Long-term follow-up of visual field progression after trabeculectomy in progressive normal-tension glaucoma

Ophthalmology ◽  
2002 ◽  
Vol 109 (4) ◽  
pp. 766-770 ◽  
Author(s):  
Takashi Shigeeda ◽  
Atsuo Tomidokoro ◽  
Makoto Araie ◽  
Nobuyuki Koseki ◽  
Seiichiro Yamamoto
Keyword(s):  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Visual Field Progression ◽  
Long Term Follow Up

scholarly journals Comparison of Perimetric Outcomes from Melbourne Rapid Fields Tablet Perimeter Software and Humphrey Field Analyzer in Glaucoma Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Harsh Kumar ◽  
Mithun Thulasidas
Keyword(s):  
Standard Deviation ◽  
Visual Field ◽  
Rural Areas ◽  
Visual Fields ◽  
Test Time ◽  
Mean Deviation ◽  
Time Saving ◽  
Humphrey Field Analyzer ◽  
Probability Plot ◽  
The Mean

Purpose. To compare visual field results obtained using Melbourne Rapid Fields (MRF) iPad-based perimeter software and Humphrey Field Analyzer (HFA) 24-2 Swedish Interactive Threshold Algorithm (SITA) standard program in glaucoma patients. Design. A cross-sectional observational study. Methods. In this single-centre study involving patients diagnosed with glaucoma, the perimetric outcomes of MRF were compared against those returned from the HFA 24-2 SITA standard. Outcomes included mean deviation (MD), pattern standard deviation (PSD), visual field index (VFI)/visual capacity (VC), foveal threshold, test time, number of points depressed at P<5% on PSD probability plot, and glaucoma hemifield test/color coded indicator. Results. The study included 28 eyes of 28 glaucoma patients. Mean (standard deviation) test times were 342.07 (56.70) seconds for MRF and 375.11 (88.95) for HFA 24-2 SITA standard P=0.046. Mean MD was significantly lower for MRF (Δ = 3.09, P<0.001), and mean PSD was significantly higher for MRF (Δ = 1.40, P=0.005) compared with HFA. The mean foveal threshold for the MRF was significantly lower than the mean HFA foveal threshold ((Δ = 9.25, P<0.001). The number of points depressed at P<5% on the PSD probability plot was significantly less for MRF P<0.001. Other perimetric outcomes showed no significant differences between both. Bland–Altman plots showed that considerable variability existed between the programs. Conclusion. MRF is a good cost-effective, time-saving, user-friendly tool for monitoring visual fields in settings where access to traditional perimetry is limited. The lack of Internet strength in rural areas and questionable detection of early cases may be two points in MRF fields requiring an upgrade.

scholarly journals Long Term Outcomes of Cataract Surgery in Severe and End Stage Glaucoma with Controlled IOP: A Retrospective Study

2019 ◽  
Author(s):  
Lin Fu ◽  
Yau Kei Chan ◽  
Junhua Li ◽  
Li Nie ◽  
Na Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Retrospective Study ◽  
Visual Field ◽  
Cataract Surgery ◽  
Final Visual Acuity ◽  
Mean Deviation ◽  
The Mean ◽  
End Stage

Abstract Background: To investigate the long term surgical outcomes of cataract surgery in severe and end glaucoma patients with preoperative intraocular pressure less than 21mmHg, and to detect the associated factors. Methods: A retrospective study of severe and end stage glaucoma patients who underwent cataract surgery or combined with goniosynechialysis from March 2015 to April 2018. Main outcome measures were visual acuity, intraocular pressure, number of glaucoma medications and complications. Results: Twenty patients (24 eyes) were included. The mean age was 64.6 ± 11.0 years and the mean followed up duration was 21.4 ± 7.3 months. The final visual acuity was significantly improved from 0.93±0.72 to 0.70±0.74, within 14 (58.3%) eyes improved, 5 (20.8%) eyes kept unchanged, and 5 (20.8%) eyes reduced. Linear regression analysis indicated that higher mean deviation, higher visual field index and lower glaucoma stage associated with greater final visual acuity improvement (r = -0.545, r = -0.501, r = 0.521 respectively). Moreover, the final number of medications were reduced from 1.1 ± 0.9 to 0.2 ± 0.5 (p < 0.01). The mean intraocular pressure was not significantly reduced with the final IOP of 13.2 ± 3.9 (6.8-25.9) mmHg (p = 0.97). While the eyes with intraocular pressure above 15 mmHg was reduced to 7 (29.2%) eyes compared to 11 (45.8%) eyes at baseline. Moreover, the number of eyes without the use of medications was increased from 6 (25%) preoperatively to 20 (83.3%) eyes postoperatively. Conclusions: Final visual acuity was significantly improved in the severe and end stage glaucoma patients and the number of eyes came off medications increased by 58.3% after cataract surgery. Preoperatively, the glaucoma stage, mean deviation and visual field index are important parameters to predict the visual acuity changes after cataract surgery.

scholarly journals Testing the Eligibility of Glaucoma Patients for Potential Gene Therapy Among a Clinic Population

2021 ◽  
Author(s):  
Rupert Bourne ◽  
Carmen Gruzei ◽  
Jufen Zhang
Keyword(s):  
Gene Therapy ◽  
Visual Field ◽  
Mean Deviation ◽  
Rapid Progression ◽  
Progression Rate ◽  
Inclusion Criteria ◽  
Putative Gene ◽  
Visual Field Progression ◽  
Fast Progression ◽  
Clinic Population

Abstract Purpose Glaucoma patients who deteriorate despite standard treatment may benefit from novel gene therapies. Key inclusion criteria for a glaucoma gene therapy trial were devised. A retrospective chart review in a glaucoma clinic population was conducted. Feasibility of gene therapy inclusion criteria and factors associated with progression and fast progression < -1 decibels/year (dB/y) were evaluated. Methods 374 Primary Open Angle Glaucoma patients all of whom had performed at least 5 Swedish Interactive Threshold Algorithm Standard visual fields within a 58 months period. Two definitions were applied to characterise visual field progression rate using Guided Progression Analysis for an individual patient based on A, the eye with the greatest visual field loss, or B, the eye with the most rapid progression rate. Results Mean rate of visual field progression was − 0.50 dB/y (Definition A) and − 0.64 dB/y (Definition B). 19.0% (A) and 21.9% (B) of eyes, 71 (A) and 82 (B) eyes, were ‘fast progressors’ (< -1 dB/y). 37 (A) and 43 (B) eyes met the putative gene therapy inclusion criteria (≥ 50 years; mean deviation ≤ -4 to ≥ -12; ≤ -20 dB, progression rate between − 1 to -4 dB/y). Beta blockers (Odds ratio (OR) with 95% Confidence Intervals (CI): 2.84 (1.39–5.80); p = 0.004) (A), (OR (95%CI): 2.48 (1.30–4.75); p = 0.006) (B) and alpha agonists (OR (95%CI): 2.18 (1.14–4.17); p = 0.02) (A), (OR (95%CI) 2.00 (1.08–3.73); p = 0.028) (B) were significantly associated with fast progression. Conclusion A substantial proportion (10%) of patients in this clinic population would meet recommended gene therapy inclusion criteria.

Impact of myopia on the association of long-term intraocular pressure fluctuation with the rate of progression in normal-tension glaucoma

2020 ◽  
pp. bjophthalmol-2019-315441
Author(s):  
Jinho Lee ◽  
Eun Jung Ahn ◽  
Yong Woo Kim ◽  
Ahnul Ha ◽  
Young Kook Kim ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Visual Field ◽  
Normal Tension Glaucoma ◽  
Mean Deviation ◽  
Linear Regression Models ◽  
Risk Effect ◽  
Rate Of Progression ◽  
Topical Medications

Background/AimsTo investigate whether the association of long-term intraocular pressure (IOP) fluctuation with the rate of progression of normal-tension glaucoma (NTG) differs between myopia and non-myopia.MethodsThe medical records of 65 myopic NTG (axial length (AL) > 24.0 mm) and 64 non-myopic NTG eyes (AL < 24.0 mm), who had been treated with topical medications for more than 5 years, were reviewed. Multiple linear regression models were fitted to analyse the relationships of the slope of mean deviation (MD) or visual field index (VFI) with the clinical factors, including the interactions with myopia.ResultsThe average follow-up period was 8.3 years. Twenty-two (22) non-myopic eyes (34.4%) and 27 myopic eyes (41.5%) showed NTG progression (p=0.511). The interaction of myopia with IOP fluctuation was a significant factor regarding both MD and VFI slope (p=0.002, 0.024, respectively); stratified analyses suggested that the risk effect of IOP fluctuation was significant only in myopic NTG in terms of both MD (β= −1.27, p=0.003) and VFI slope (β=−2.32, p=0.011).ConclusionLong-term IOP fluctuation was significantly related to faster visual field progression in myopic NTG eyes, compared with non-myopic NTG eyes.

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