Are rates of vision loss in patients in English glaucoma clinics slowing down over time? Trends from a decade of data

Abstract

Purpose To examine changes in rates of visual field (VF) progression in patients attending a sample of glaucoma clinics in England between 1999 and 2012. Methods An archive of 473 252 Humphrey VFs recorded across the UK was retrospectively examined. Distribution of rates recorded in the first half of the decade was compared with the second. The relationship between age and severity of MD loss at baseline with rates of loss and frequency of testing was examined. Results VF series from 18 926 eyes were analysed. Median rate of MD loss for the period before and after 2003 was − 0.11 and − 0.06 dB/year, respectively, but the proportion of eyes with medium or fast rates of MD loss remained constant. Median rate of MD loss in older (470 years) eyes was faster than that observed in younger (o60 years) eyes (−0.21 compared with − 0.01 dB/ year). Median rate of loss did not vary with severity of MD loss at baseline. Frequency of testing, typically carried out annually, did not vary by age, rate of loss or disease severity. Conclusions VFs of eyes treated in the first half of the decade deteriorated more rapidly than those in the second half. Several factors might explain these differences but average effects were small and there was no reduction in the proportion of rapidly progressing eyes over the decade. Older age and, to a lesser extent, worse VF damage at diagnosis are indicators for faster VF loss in clinics, but frequency of VF testing was similar for all patients.

Evaluating the Impact of Uveitis on Visual Field Progression Using Large-Scale Real-World Data

“…As with previous studies, a fast-progressing VF series was defined as having a rate of progression slope of > _1.5 dB/year. 13,18 A crude relative risk (RR) was calculated as the ratio of the proportion of fast progressors in the uveitis and POAG groups, for each 10-year age group from 40 to 100 years, as estimated by the OLS regression slopes. An overall age-adjusted RR was calculated using the direct method.…”

“…Such ''Big Data'' approaches have been successfully used to characterize the population and predict outcomes in other ophthalmic diseases. [11][12][13][14][15] This study aims to use largescale EMR data for comparing the rate of visual field (VF) loss in uveitis patients with glaucoma, compared to those with primary open-angle glaucoma (POAG), and explore whether this is associated with IOP.…”

Does eye examination order for standard automated perimetry matter?

“…As described elsewhere, Medisoft VF databases (Medisoft Ltd., Leeds, UK) containing 473 252 VFs from 88 954 patients were extracted in 2012 from glaucoma clinics at Moorfields Eye Hospital in London; Cheltenham General Hospital Gloucestershire Eye Unit; Queen Alexandra Hospital in Portsmouth and the Calderdale and Huddersfield NHS Foundation Trust (Boodhna & Crabb ; Boodhna et al. ; Saunders et al. ).…”

Example of monitoring measurements in a virtual eye clinic using ‘big data’

“…These data are described elsewhere19 and were pooled from 88 954 patients from four centres in the UK: MEH NHS Foundation Trust, London; Cheltenham General Hospital Gloucestershire Eye Unit; Queen Alexandra Hospital, Portsmouth; and the Calderdale and Huddersfield NHS Foundation Trust. Only patients tested using the 24-2 testing algorithm were included, resulting in a total of 83 794 patients.…”