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

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.