Risk Factors for Visual Field Progression in Treated Glaucoma

Moraes, Carlos Gustavo V. De

doi:10.1001/archophthalmol.2011.72

Cited by 302 publications

(254 citation statements)

References 57 publications

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“…Still, several studies, both prospective and retrospective, have derived estimates of average rate of VF loss in groups of patients. [1][2][3] Indeed, knowledge of the distribution of rates of loss in populations as defined by mean deviation (MD) loss per year, where MD is a commonly used metric for assessing severity of VF loss, is clinically useful information. Recent studies, using data from treated patients in routine care, have yielded estimates for median rate of MD loss that vary considerably from − 0.05 to − 0.62 dB/year.…”

Section: Introductionmentioning

confidence: 99%

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

Boodhna

Saunders

Crabb

2015

Eye

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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.

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Section: Introductionmentioning

confidence: 99%

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

Boodhna

Saunders

Crabb

2015

Eye

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“…Differences in the definition of visual field progression may also explain the disparities between our results. Previous studies 20,[35][36][37][38] have shown that different progression criteria do not necessarily identify the same eyes as progressing. The study by Medeiros and colleagues defined SAP progression using an event analysis derived from the Early Manifest Glaucoma Trial 39 consisting of a change in three or more of the same test points on three follow-up consecutive tests.…”

Section: Discussionmentioning

confidence: 96%

“…Progression with PLR criteria was defined as 2 contiguous locations in the same hemifield that were losingZ1.0 dB/year with Po0.01. 20,21 All patients had visual fields and OCT imaging performed on the same day. The average number of visual fields included in the progression analysis was 9.75 ± 2.2 (range 5-15) for each patient.…”

Section: Oct Imaging and Analysismentioning

confidence: 99%

Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Niles

Greenfield

Sehi

et al. 2012

Eye

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Aims To examine the rate of macular thickness loss using time-domain optical coherence tomography (OCT) in functionally progressing versus non-progressing eyes, determined by standard automated perimetry (SAP). Methods Glaucoma suspects (GS) and glaucomatous (G) eyes underwent SAP and OCT imaging every 6 months. Functional progression was determined using pointwise linear regression, defined as 2 contiguous locations losing Z1.0 dB/year at Po1.0% in the same hemifield. The annual rate of macular thickness loss was calculated from inner and outer regions of the macular map. Results 72 eyes (43 GS and 29G) with Z30 months of follow-up were enroled. Fourteen eyes demonstrated SAP progression. The annual rate of macular thickness loss (mm/year) in progressing eyes was faster (all Po0.05) than non-progressing eyes in temporal outer ( À 1.90±2.97 vs 0.33±2.77), nasal inner ( À 1.70±2.66 vs 0.14±2.76), superior inner ( À 2.15 ± 4.57 vs 0.51 ± 2.99), temporal inner quadrants ( À 2.58 ± 5.05 vs À 0.38 ± 2.34), and the average of inner macular quadrants ( À 1.84 ± 2.90 vs 0.03 ± 2.10). The rate of loss in the nasal inner (P ¼ 0.02) and temporal outer (P ¼ 0.02) macular regions was associated with optic disc haemorrhage. Conclusions Eyes with SAP progression have significantly greater rates of macular thickness loss consistent with glaucomatous retinal ganglion cell atrophy, as compared with non-progressing eyes.

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“…Although it is a well-established clinical fact that very high intraocular pressure (IOP), higher than blood perfusion pressure, is able to induce ischemic damage [18], the presence of glaucomatous changes in patients with moderately increased, normal or even low pressure, without demonstrable pressure spikes, cannot be directly attributed to pressure, and thus additional explanations have been sought [19]. Raised intraocular pressure has been discarded as "the" causative factor and now ranks alongside other risk factors.…”

Section: Glaucoma: How Many Different Diseases?mentioning

confidence: 99%

Glaucoma as a Tax on Hominid Evolution. Constraints of the Experimental Animal Models of Glaucoma

Carreras¹

2016

J Clin Exp Ophthalmol

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Glaucoma continues to be a mysterious disease. High intraocular pressure (IOP), once the landmark of the disease, has been relegated to the humble role of risk factor, despite the fact that lowering IOP continues to be the only partially successful treatment. Even with an IOP successfully controlled to statistical standards, many patients still mysteriously continue to progressively lose neural tissue. A novel pathogenetical mechanism has recently been put forward as the main agent of the disease. In this new light, some structural details of the human eye, the result of the peculiar evolutionary development, take on an unexpected role in the presentation of the disease. As results of cladistics analysis, the human eye appears as particularly prone to suffering glaucoma as a consequence of the evolutionary path taken. That makes glaucoma essentially a human (and related hominid) scourge. Exclusive features of the human eye compared to other vertebrates involve both the anterior and posterior segment. Those features that facilitate glaucoma in humans are absent in many of the purported animal models for the disease, and this inadequacy further convolutes the mystery of glaucoma. This suggests the division of the animal models into those that mimic the whole disease and those that only reproduce a pertinent histological feature. Unfortunately most animal models are based on high intraocular pressure which excludes most cases of low or moderate pressure. For any animal model, it is important the researcher accurately establishes the constraints of the model in order to avoid jumping to conclusions.

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Risk Factors for Visual Field Progression in Treated Glaucoma

Cited by 302 publications

References 57 publications

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

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

Detection of progressive macular thickness loss using optical coherence tomography in glaucoma suspect and glaucomatous eyes

Glaucoma as a Tax on Hominid Evolution. Constraints of the Experimental Animal Models of Glaucoma

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