The risk of newly developed visual impairment in treated normal‐tension glaucoma: 10‐year follow‐up

Choi, Yun Jeong; Kim, Martha; Park, Ki Ho; Kim, Dong M.yung; Kim, Seok Hwan

doi:10.1111/aos.12411

Cited by 10 publications

(8 citation statements)

References 27 publications

(38 reference statements)

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“…; Choi et al. ). One large cohort study was performed in the USA and has resulted in many analyses published, and one other was performed in Sweden.…”

Section: Discussionmentioning

confidence: 98%

“…Only a few numbers of studies have evaluated the progression of visual field defects in glaucoma patients treated and followed by usual care (De Moraes et al 2009, 2011, 2013aFolgar et al 2010;Prata et al 2010;Heijl et al 2013;Bertrand et al 2014;Choi et al 2014). One large cohort study was performed in the USA and has resulted in many analyses published, and one other was performed in Sweden.…”

Section: Discussionmentioning

confidence: 99%

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Progression of visual field in patients with primary open‐angle glaucoma – ProgF study 1

Aptel

Aryal-Charles

Giraud

et al. 2015

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the visual field rate of progression of patients with treated ocular hypertension (OHT) and primary open-angle glaucoma (POAG) in clinical practice, using the mean deviation (MD) and the visual field index (VFI). Methods: Non-interventional cohort study. From a large multicentre database representative of the French population, 441 eyes of 228 patients with treated OHT or POAG followed up at least 6 years with Humphrey 24.2 Sita-Standard visual field examination at least twice a year were identified. From initial data, eyes were classified in five groups: 121 with OHT, 188 with early glaucoma (MD greater than À6 dB), 45 with moderate glaucoma (MD À6 to À12 dB), 41 with advanced glaucoma (MD À12 to À18 dB) and 46 with severe glaucoma (MD less than À18 dB). Rate of progression during the follow-up period was calculated using the trend analysis of the Guided Progression Analysis software. Results: The mean duration of follow-up was 8.4 AE 2.7 years and the mean number of visual field, 18.4 AE 3.5. In eyes with OHT, rate of progression was À0.09 dB/year (À0.17%VFI/year). In eyes with POAG, rate of progression was À0.32 dB/year (À0.83%VFI/year) in eyes with early glaucoma, À0.52 dB/ year (À1.81%VFI/year) in moderate glaucoma, À0.54 dB/year (À2.35%VFI/ year) in advanced glaucoma and À0.45 dB/year (À1.97%VFI/year) in severe glaucoma. In eyes with POAG, a significant progression (p < 0.05) was detected in 159 of 320 eyes (49.7%) with trend analysis and 117 of 320 eyes (36.6%, likely progression) or 183 of 320 eyes (57.2%, possible and likely progression) with event analysis.Conclusions: Primary open-angle glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow-up. The rate of progression varies greatly among subjects.

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“…; Choi et al. ). One large cohort study was performed in the USA and has resulted in many analyses published, and one other was performed in Sweden.…”

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Progression of visual field in patients with primary open‐angle glaucoma – ProgF study 1

Aptel

Aryal-Charles

Giraud

et al. 2015

Acta Ophthalmologica

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“…About 20% of such patients experience progressive optic neuropathy five years after 30% IOP reduction from normal baseline levels 3 , even sometimes to such deeply subnormal IOP that ocular hypotension then poses a separate risk of vision loss 29 . Therefore, without denying the clear pathogenic role of highly elevated IOP, there seemingly exist one or more IOP-independent mechanisms of progressive optic neuropathy that operate at normal IOP and can be unresponsive to IOP reduction 30,31 .…”

Section: Introductionmentioning

confidence: 99%

Optic Nerve Traction During Adduction in Open Angle Glaucoma with Normal versus Elevated Intraocular Pressure

Demer

Clark

Suh

et al. 2019

Current Eye Research

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Purpose/Aim: We used magnetic resonance imaging (MRI) to investigate effects of intraocular pressure (IOP), race, and other factors on optic nerve (ON) traction in adduction, a phenomenon proposed as neuropathic in open angle glaucoma (OAG). Materials and Methods:Thirty-five patients with OAG (26 with maximal untreated IOP ≤21mmHg, 9 with IOP >21mmHg) and 48 controls underwent axial and quasi-coronal MRI in central gaze and large (27-33°) abduction and adduction. Some underwent MRI at smaller ductions (21-28°). Effects of presence vs. absence of OAG; within OAG whether maximum IOP level was ≤21mmHg vs. >21mmHg; adduction angle; race; age; and gender on ON path length and globe translation were analyzed using generalized estimating equations to account for possible intereye correlations of individual subjects.Results: Average visual field mean deviation (±standard error of mean, SEM) was −8.2±1.2 dB in OAG with normal IOP, and −6.1±1.4 in high IOP. In central gaze, ON path in OAG was significantly more redundant than in controls but in both groups the ON became significantly and almost equally straighter in small (~21°) or large (~27°) adduction than in central gaze. With progressive adduction only, globes retracted in OAG (P<0.005) but not in controls; this was only weakly related to globe size and not to IOP elevation. Globe retraction in adduction was significant only in OAG, and in that group was significantly greater in Asian than white patients (P<0.02). Conclusions:Although ON tethering in adduction is normal, progressive adduction is associated with abnormal globe retraction, in OAG regardless of IOP level. This phenomenon is more prominent in Asians who have OAG. Traction in adduction may cause repetitive strain injury

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“…Notwithstanding that IOP reduction may slow the glaucomatous process in some of these patients, 11 – 13 there clearly must exist an IOP-independent mechanism of progressive optic neuropathy unresponsive to IOP reduction to any level. 10 , 14 …”

mentioning

confidence: 99%

Magnetic Resonance Imaging of Optic Nerve Traction During Adduction in Primary Open-Angle Glaucoma With Normal Intraocular Pressure

Demer

Clark

Suh

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeWe used magnetic resonance imaging (MRI) to ascertain effects of optic nerve (ON) traction in adduction, a phenomenon proposed as neuropathic in primary open-angle glaucoma (POAG).MethodsSeventeen patients with POAG and maximal IOP ≤ 20 mm Hg, and 31 controls underwent MRI in central gaze and 20° to 30° abduction and adduction. Optic nerve and sheath area centroids permitted computation of midorbital lengths versus minimum paths.ResultsAverage mean deviation (±SEM) was −8.2 ± 1.2 dB in the 15 patients with POAG having interpretable perimetry. In central gaze, ON path length in POAG was significantly more redundant (104.5 ± 0.4% of geometric minimum) than in controls (102.9 ± 0.4%, P = 2.96 × 10−4). In both groups the ON became significantly straighter in adduction (28.6 ± 0.8° in POAG, 26.8 ± 1.1° in controls) than central gaze and abduction. In adduction, the ON in POAG straightened to 102.0% ± 0.2% of minimum path length versus 104.5% ± 0.4% in central gaze (P = 5.7 × 10−7), compared with controls who straightened to 101.6% ± 0.1% from 102.9% ± 0.3% in central gaze (P = 8.7 × 10−6); and globes retracted 0.73 ± 0.09 mm in POAG, but only 0.07 ± 0.08 mm in controls (P = 8.8 × 10−7). Both effects were confirmed in age-matched controls, and remained significant after correction for significant effects of age and axial globe length (P = 0.005).ConclusionsAlthough tethering and elongation of ON and sheath are normal in adduction, adduction is associated with abnormally great globe retraction in POAG without elevated IOP. Traction in adduction may cause mechanical overloading of the ON head and peripapillary sclera, thus contributing to or resulting from the optic neuropathy of glaucoma independent of IOP.

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The risk of newly developed visual impairment in treated normal‐tension glaucoma: 10‐year follow‐up

Cited by 10 publications

References 27 publications

Progression of visual field in patients with primary open‐angle glaucoma – ProgF study 1

Progression of visual field in patients with primary open‐angle glaucoma – ProgF study 1

Optic Nerve Traction During Adduction in Open Angle Glaucoma with Normal versus Elevated Intraocular Pressure

Magnetic Resonance Imaging of Optic Nerve Traction During Adduction in Primary Open-Angle Glaucoma With Normal Intraocular Pressure

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