Long-term clinical course of normotensive preperimetric glaucoma

Sawada, Akira; Manabe, Yusuke; Yamamoto, Tetsuya; Nagata, Chisato

doi:10.1136/bjophthalmol-2016-309401

Cited by 17 publications

(10 citation statements)

References 25 publications

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“… 1 , 2 Here, we found that the slope of average MD (−0.17 ± 0.72 dB/y) and TD (−1.02 ± 4.54 dB/y) significantly decreased in our normotensive PPG patients during the follow-up period of this study, regardless of the IOP-lowering treatment. Previous retrospective studies have reported that the average MD slope in PPG eyes ranged from −0.09 to −0.39 dB/y, that more than 50% of eyes developed glaucomatous visual field loss within a 5-year follow-up period, 14 , 15 and that IOP-lowering therapy was effective for controlling visual field progression in PPG eyes. 10 The risk of visual field progression in untreated PPG eyes is considered to be high, so the PPG eyes enrolled in the above-mentioned studies, as well as those in the present study, received topical treatment with IOP-lowering agents.…”

Section: Discussionmentioning

confidence: 98%

Preperimetric Glaucoma Prospective Study (PPGPS): Predicting Visual Field Progression With Basal Optic Nerve Head Blood Flow in Normotensive PPG Eyes

Shiga

Aizawa

Tsuda

et al. 2018

Trans. Vis. Sci. Tech.

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PurposeTo investigate the site specificity of visual field changes in eyes with normotensive preperimetric glaucoma (PPG), and to determine factors influencing visual field progression.MethodsThis prospective study comprised 84 eyes of 84 normotensive PPG patients followed for at least 16 months. Optic nerve head (ONH) blood flow was assessed with tissue-area mean blur rate (MBRT), derived from laser speckle flowgraphy. Total deviation (TD) was measured in each sector of the Garway-Heath map to evaluate the site specificity of visual field loss. Subjects with a TD slope in the first quartile were classified as progressive, and other subjects as nonprogressive. Linear and multiple regression analyses were performed to determine factors affecting visual field progression.ResultsTD in the superior sector significantly decreased in the subjects overall during the follow-up periods (−0.48 ± 1.92 dB/y, P = 0.025). Linear regression analysis showed that basal MBRT-inferior was correlated significantly with TD-superior slope (r = 0.332, P = 0.002). Furthermore, basal MBRT was significantly lower in this sector in the progressive than the nonprogressive group (P = 0.010). Multiple linear regression analysis revealed that basal MBRT-inferior was the only predictive factor for TD-superior slope (β = 0.329, P = 0.005).ConclusionsThese findings suggest that superior-sector visual field progression is most common in normotensive PPG eyes, and that reduced basal ONH blood flow is associated with visual field progression.Translational RelevanceThese findings provide new insight into the involvement of ONH blood flow impairment in glaucoma pathogenesis, and demonstrate the importance of assessing ONH blood flow to determine visual field progression in normotensive PPG.

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Section: Discussionmentioning

confidence: 98%

Preperimetric Glaucoma Prospective Study (PPGPS): Predicting Visual Field Progression With Basal Optic Nerve Head Blood Flow in Normotensive PPG Eyes

Shiga

Aizawa

Tsuda

et al. 2018

Trans. Vis. Sci. Tech.

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“…To our knowledge, this is the first study to apply commercially available SS-OCT probability maps to PPG patients. Some reports show that VF defect progresses during follow-up in approximately 50% to 60% PPG patients, 20,21,25 though results vary with follow-up duration. For the purposes of diagnosis and prediction of VF progression in such PPG patients, recent studies have evaluated the usefulness of advanced OCT technology.…”

Section: Discussionmentioning

confidence: 99%

Can Probability Maps of Swept-Source Optical Coherence Tomography Predict Visual Field Changes in Preperimetric Glaucoma?

Lee

Kim

Jeoung

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…77 Another trial that specifically examined patients with so-called 'pre-perimetric' lowtension glaucoma (using current clinical guidelines, this would be the earliest stage of glaucoma) showed that around half do not develop a glaucomatous visual field defect over time. 78 A large United Kingdom-based trial showed that around three-quarters of patients without treatment had eventual glaucomatous progression at two years, and similarly raised the question of whether a period of observation could be used to individualise rates of change, with the caveat that sensitive detection methods are required. 79 A subsequent question is whether delayed treatment may influence the final prognosis.…”

Section: Evidence For Major Shift 1: the Need For Glaucoma Treatment Should Be Titrated And Individualisedmentioning

confidence: 99%

Management of open‐angle glaucoma by primary eye‐care practitioners: toward a personalised medicine approach

Phu

Agar

Wang

et al. 2021

Clinical and Experimental Optometry

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Glaucoma is the leading cause of irreversible blindness worldwide. As a chronic disease, glaucoma presents a significant burden to the individual, health-care provider and the health-care system. Currently, strategies for treating glaucoma are focused on lowering intraocular pressure, which is aimed at slowing or arresting disease progression over time. This is the only current accepted therapeutic strategy for glaucoma, and can be achieved using topical drugs, laser trabeculoplasty, filtration surgery or cyclodestructive techniques. The lowering of intraocular pressure has been wellsupported by numerous large-scale seminal clinical trials in primary open-angle glaucoma, in both its early and advanced stages. Although such guidance remains current, in the last 10-years, there has been a significant evolution in preferred first-line therapies in the treatment of open-angle glaucoma with a resultant shift in practice patterns, particularly early in the course of the disease. These changes reflect both from the perspective of the doctor -in titrating the most effective and least risky treatment modality -and the perspective of the patient, in consenting to a treatment that preserves vision and results in minimal negative impact on quality of life. In this review, the most recent evidence regarding treatment modalities for early primary open-angle glaucoma is presented and an updated framework for management guidance is proposed.

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Long-term clinical course of normotensive preperimetric glaucoma

Abstract: Our findings confirmed that the mean IOP, but not the IOP fluctuation, is strongly associated with the development of a VFD in cases of PPG.

Cited by 17 publications

References 25 publications

Preperimetric Glaucoma Prospective Study (PPGPS): Predicting Visual Field Progression With Basal Optic Nerve Head Blood Flow in Normotensive PPG Eyes

Preperimetric Glaucoma Prospective Study (PPGPS): Predicting Visual Field Progression With Basal Optic Nerve Head Blood Flow in Normotensive PPG Eyes

Can Probability Maps of Swept-Source Optical Coherence Tomography Predict Visual Field Changes in Preperimetric Glaucoma?

Management of open‐angle glaucoma by primary eye‐care practitioners: toward a personalised medicine approach

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