Risk Factors for Visual Field Progression in New-diagnosed Exfoliation Glaucoma Patients in Sweden.

Exfoliation Glaucoma

Abstract Purpose: The present study aimed to identify risk factors for visual field progression in new-diagnosed exfoliation glaucoma patients. Methods: Prospective non-randomized cohort study. The study included patients with new-diagnosed exfoliation glaucoma. All patients were followed for at least three years with reliable visual fields. Both risk factors at inclusion and during the three years follow-up were considered. For inclusion, five reliable visual fields were needed. Exfoliation glaucoma was defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the 24-2 strategy of the Humphrey Field Analysis. Outcomes: Visual field progression. Three different approaches were used: mean deviation (MD), visual field index (VFI), and guided progression analysis (GPA). Results: The results were different in the three different models used (MD, VFI and GPA). The only variable that showed a significant association in the three models was age (p= 0.004; p=0.006; p=0.04). Significant variables in two models were: IOP at diagnose (p=0.02; p=0.04), IOP reduction in absolute terms (p=0.006; p=0.003), IOP reduction in relative terms (%) (p=0.04; p=0.009) and number of medicines (p=0.02; p=0.002). Significant variables in one model were: family history (p=0.04), smoking (p=0.03), cataract surgery (p=0.04) and SLT treatment (p=<0.001). Conclusion: Exfoliation glaucoma is fast progressive glaucoma. Age at diagnosing must be considered. Significant IOP reduction must be achieved to slow down progress in exfoliation glaucoma. The use of SLT treatment should be advised in exfoliation glaucoma patients.

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

European Journal of Ophthalmology ◽

10.1177/112067210701700411 ◽

2007 ◽

Vol 17 (4) ◽

pp. 545-549 ◽

Cited By ~ 14

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.

Classification and Statistical Trend Analysis in Detecting Glaucomatous Visual Field Progression

Journal of Ophthalmology ◽

10.1155/2019/1583260 ◽

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 ◽

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 ◽

10.1093/neuros/nyaa318 ◽

2020 ◽

Vol 88 (1) ◽

pp. 106-112 ◽

Cited By ~ 1

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 (>5%) and thin (<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.

Comparison of visual field progression in new-diagnosed primary open-angle and exfoliation glaucoma patients in Sweden.

10.21203/rs.3.rs-34864/v2 ◽

2020 ◽

Author(s):

Marcelo Ayala

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

T Test ◽

Open Angle ◽

Exfoliation Glaucoma ◽

The Difference ◽

Abstract Background: The present study aimed to compare visual field progression in new-diagnosed exfoliation versus open-angle glaucoma patients. Methods: Retrospective study. The study included patients with new-diagnosed primary open-angle and exfoliation glaucoma. All patients were followed for three years with reliable visual fields. At least five reliable fields were needed for inclusion. Exfoliation and open-angle glaucoma were defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the software threshold 24-2 of the Humphrey Field Analysis. Outcomes: Visual field progression. For visual field progression, three different strategies were used: mean deviation (MD), visual field index (VFI), and the guided progression analysis (GPA). Results: The study included 128 subjects, of the 54 in the open-angle and 74 in the exfoliation glaucoma group. The MD difference values were higher in the exfoliation (-3.17 dB) than in the primary open-angle (-1.25 dB) glaucoma group in the three-year follow-up period. The difference between groups was significant (t-test, p=<0.001). The difference in VFI was calculated for the three years follow-up period. The difference was higher in the exfoliation (-7.65%) than in the primary open (-1.90%) glaucoma group (t-test, p=<0.001). The GPA showed progression in 58% of cases in exfoliation, and 13% in primary open glaucoma group (Chi-square, p=<0.001). Conclusion: The present study found a more frequent and faster visual field progression in exfoliation than in primary open-angle glaucoma patients. New-diagnosed exfoliation glaucoma patients must be controlled and treated more strictly than primary open-angle glaucoma patients to avoid visual field deterioration.

Comparison of visual field progression in new-diagnosed primary open-angle and exfoliation glaucoma patients in Sweden

BMC Ophthalmology ◽

10.1186/s12886-020-01592-w ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Marcelo Ayala

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

T Test ◽

Open Angle ◽

Exfoliation Glaucoma ◽

The Difference ◽

Abstract Background The present study aimed to compare visual field progression in new-diagnosed exfoliation versus open-angle glaucoma patients. Methods Retrospective study. The study included patients with new-diagnosed primary open-angle and exfoliation glaucoma. All patients were followed for 3 years with reliable visual fields. At least five reliable fields were needed for inclusion. Exfoliation and open-angle glaucoma were defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the software threshold 24–2 of the Humphrey Field Analysis. Outcomes: Visual field progression. For visual field progression, three different strategies were used: mean deviation (MD), visual field index (VFI), and the guided progression analysis (GPA). Results The study included 128 subjects, of the 54 in the open-angle and 74 in the exfoliation glaucoma group. The MD difference values were higher in the exfoliation (− 3.17 dB) than in the primary open-angle (− 1.25 dB) glaucoma group in the three-year follow-up period. The difference between groups was significant (t-test, p = < 0.001). The difference in VFI was calculated for the 3 years follow-up period. The difference was higher in the exfoliation (− 7.65%) than in the primary open (− 1.90%) glaucoma group (t-test, p = < 0.001). The GPA showed progression in 58% of cases in exfoliation, and 13% in primary open glaucoma group (Chi-square, p = < 0.001). Conclusion The present study found a more frequent and faster visual field progression in exfoliation than in primary open-angle glaucoma patients. New-diagnosed exfoliation glaucoma patients must be controlled and treated more strictly than primary open-angle glaucoma patients to avoid visual field deterioration.

Long Term Results of Visual Field Progression Analysis in Open Angle Glaucoma Patients Under Treatment

The Open Ophthalmology Journal ◽

10.2174/1874364101509010116 ◽

2015 ◽

Vol 9 (1) ◽

pp. 116-120 ◽

Cited By ~ 2

Author(s):

Tolga Kocatürk ◽

Sinan Bekmez ◽

Merve Katrancı ◽

Harun Çakmak ◽

Volkan Dayanır

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

Long Term Results ◽

Mean Deviation ◽

Event Analysis ◽

Open Angle ◽

Department Of Ophthalmology

Purpose : To evaluate visual field progression with trend and event analysis in open angle glaucoma patients under treatment. Materials and Methods : Fifteen year follow-up results of 408 eyes of 217 glaucoma patients who were followed at Adnan Menderes University, Department of Ophthalmology between 1998 and 2013 were analyzed retrospectively. Visual field data were collected for Mean Deviation (MD), Visual Field Index (VFI), and event occurrence. Results : There were 146 primary open-angle glaucoma (POAG), 123 pseudoexfoliative glaucoma (XFG) and 139 normal tension glaucoma (NTG) eyes. MD showed significant change in all diagnostic groups (p<0.001). The difference of VFI between first and last examinations were significantly different in POAG (p<0.001), and XFG (p<0.003) but not in NTG. VFI progression rates were -0.3, -0.43, and -0.2 % loss/year in treated POAG, XFG, and NTG, respectively. The number of empty triangles were statistically different between POAG-NTG (p=0.001), and XFG-NTG (p=0.002) groups. The number of half-filled (p=0.002), and full-filled (p=0.010) triangles were significantly different between XFG-NTG groups. Conclusion : Functional long-term follow-up of glaucoma patients can be monitored with visual field indices. We herein report our fifteen year follow-up results in open angle glaucoma.

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

Journal of Ophthalmology ◽

10.1155/2017/2651645 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 4

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 ◽

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.

Population-based associations between progression of normal-tension glaucoma and Yang-deficient constitution among Chinese persons

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2021-319210 ◽

2021 ◽

pp. bjophthalmol-2021-319210

Author(s):

Lewei Tang ◽

Liang Chen ◽

Cong Ye ◽

Jingwei Zheng ◽

Yi Zhou ◽

...

Keyword(s):

Intraocular Pressure ◽

Chinese Medicine ◽

Visual Field ◽

Traditional Chinese Medicine ◽

Normal Tension Glaucoma ◽

Population Based ◽

The Body ◽

Mean Deviation ◽

Visual Field Progression

PurposeTo explore the association between constitution types as defined by traditional Chinese medicine (TCM) and risk for normal-tension glaucoma (NTG).DesignPopulation-based cohort study.MethodsPersons were identified in a population cohort aged ≥30 years with NTG, defined as having an untreated mean intraocular pressure measurement ≤21 mm Hg over six separate occasions, with no single reading >24 mm Hg (as in the Collaborative Normal Tension Glaucoma Study). The Body Constitution in Traditional Chinese Medicine Questionnaire was used to assess each participant’s TCM constitution types. The association between various constitutions and visual field progression according to Early Manifest Glaucoma Trial criteria was assessed using Cox regression HR models.ResultsAmong 142 participants (245 eyes), 23 persons (17.6%) and 25 eyes (10.2%) progressed, over a mean (SD) follow-up duration of 3.49 (0.99) years. Progression rates were highest in participants with Yang-deficient constitution (n=19, 13.4%), among whom 7 (36.8%) exhibited worsening fields. After adjusting for sex, age, central corneal thickness, retinal nerve fibre layer thickness and mean deviation on visual field testing, Yang-deficient constitution (HR 4.63, 95% CI 1.77 to 12.1, p=0.002) and higher mean intraocular pressure during follow-up (HR 1.25, 95% CI 1.01 to 1.56, p=0.044) were associated with field progression.ConclusionsYang-deficient constitution and higher intraocular pressure are risk factors for visual field progression in NTG patients. Yang deficiency is characterised by abnormal vasoregulation, and these results may be consistent with prior studies linking NTG progression to Raynaud’s phenomenon and migraine.

Comparison of visual field progression in new-diagnosed primary open-angle and exfoliation glaucoma patients in Sweden.

10.21203/rs.3.rs-34864/v3 ◽

2020 ◽

Author(s):

Marcelo Ayala

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

T Test ◽

Open Angle ◽

Exfoliation Glaucoma ◽

The Difference ◽

Comparison of visual field progression in new-diagnosed primary open-angle and exfoliation glaucoma patients in Sweden

10.21203/rs.3.rs-34864/v1 ◽

2020 ◽

Author(s):

Marcelo Ayala

Keyword(s):

Visual Field ◽

Open Angle Glaucoma ◽

T Test ◽

Open Angle ◽

Exfoliation Glaucoma ◽

The Difference ◽

Abstract Background The present study aimed to compare visual field progression in new-diagnosed exfoliation versus open-angle glaucoma patients. Methods Retrospective study. The study included patients with new-diagnosed primary open-angle and exfoliation glaucoma. All patients were followed for three years with reliable visual fields. At least five reliable fields were needed for inclusion. Exfoliation and open-angle glaucoma were defined based on the European Glaucoma Society guidelines. Visual field evaluation was performed using the software threshold 24 − 2 of the Humphrey Field Analysis. Outcomes: Visual field progression. For visual field progression, three different strategies were used: mean deviation (MD), visual field index (VFI), and the guided progression analysis (GPA). Results The study included 128 subjects, of the 54 in the open-angle and 74 in the exfoliation glaucoma group. The MD difference values were higher in the exfoliation (-3.17 dB) than in the primary open-angle (-1.25 dB) glaucoma group in the three-year follow-up period. The difference between groups was significant (t-test, p = < 0.001). The difference in VFI was calculated for the three years follow-up period. The difference was higher in the exfoliation (-7.65%) than in the primary open (-1.90%) glaucoma group (t-test, p = < 0.001). The GPA showed progression in 58% of cases in exfoliation, and 13% in primary open glaucoma group (Chi-square, p = < 0.001). Conclusion The present study found a more frequent and faster visual field progression in exfoliation than in primary open-angle glaucoma patients. New-diagnosed exfoliation glaucoma patients must be controlled and treated more strictly than primary open-angle glaucoma patients to avoid visual field deterioration.