Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 May;25(5):626-32.
doi: 10.1038/eye.2011.33. Epub 2011 Mar 11.

Baseline mean deviation and rates of visual field change in treated glaucoma patients

I Forchheimer  1 , C G de Moraes, C C Teng, F Folgar, C Tello, R Ritch, J M Liebmann
Affiliations

Baseline mean deviation and rates of visual field change in treated glaucoma patients

I Forchheimer et al. Eye (Lond). 2011 May.

Abstract

Purpose: To evaluate the relationships between baseline visual field (VF) mean deviation (MD) and subsequent progression in treated glaucoma.

Methods: Records of patients seen in a glaucoma practice between 1999 and 2009 were reviewed. Patients with glaucomatous optic neuropathy, baseline VF damage, and ≥8 SITA-standard 24-2 VF were included. Patients were divided into tertiles based upon baseline MD. Automated pointwise linear regression determined global and localized rates (decibels (dB) per year) of change. Progression was defined when two or more adjacent test locations in the same hemifield showed a sensitivity decline at a rate of >1.0 dB per year, P<0.01.

Results: For mild, moderate, and severe groups, progression was noted in 29.5, 31.2, and 26.0% of eyes (P=0.50) and global rates of VF change of progressing eyes were -1.3±1.2, -1.01±0.7, and -0.9±0.5 dB/year (P=0.09, analysis of variance). Within these groups, intraocular pressure (IOP) in stable vs progressing eyes were 15.5±3.3 vs 17.0±3.1 (P<0.01), 15.4±3.3 vs 15.9±2.5 (P=0.28), and 14.0±2.8 vs 14.8±2.3 mm Hg (P=0.07). More glaucoma filtering surgeries were performed in eyes with worse MD. There was no significant difference between groups regarding their risk of progression in both univariate (P=0.50) and multivariate (P=0.26) analyses adjusting for differences in follow-up IOP.

Conclusions: After correcting for differences in IOP in treated glaucoma patients, we did not find a relationship between the rate of VF change (dB per year) and the severity of the baseline VF MD. This finding may have been due to more aggressive IOP lowering in eyes with more severe disease. Eyes with lower IOP progressed less frequently across the spectrum of VF loss.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Rate (%) of eyes that reached a progression end point based on the baseline visual field (VF) damage and mean treated intraocular pressure (IOP). formula image, 1st IOP tertile; formula image, 2nd IOP tertile; formula image, 3rd IOP tertile. Mean IOP values for each tertile: mild: <14.68, 14.68–17.45, and 17.45–23.81 mm Hg; moderate: <14.50, 14.50–16.80, and 16.80–22.81 mm Hg; severe: <13.31, 13.31–15.35, and 15.35–21.58 mm Hg.
Figure 2
Figure 2
Rates of global visual field (VF) change based on the baseline level of VF damage and mean follow-up intraocular pressure (IOP). formula image, 1st IOP tertile; formula image, 2nd IOP tertile; formula image, 3rd IOP tertile. Mean IOP values for each tertile: mild: <14.68, 14.68–17.45, and 17.45–23.81 mm Hg; moderate: <14.50, 14.50–16.80, and 16.80–22.81 mm Hg; severe: <13.31, 13.31–15.35, and 15.35–21.58 mm Hg.
Figure 3
Figure 3
Global rates of visual field (VF) change (dB per year) among patients with different levels of baseline VF damage based on their peak intraocular pressure (IOP). formula image, 1st IOP tertile; formula image, 2nd IOP tertile.
Figure 4
Figure 4
Mean intraocular pressure (IOP) between stable eyes and eyes that reached a progression end point. formula image, 1st IOP tertile; formula image, 2nd IOP tertile.
See this image and copyright information in PMC

References

    1. Kass MA, Heuer DK, Higginbotham EJ, Johnson CA, Keltner JL, Miller JP, et al. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 2002;120:701–713. - PubMed
    1. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M. Early Manifest Glaucoma Trial Group. Reduction of intraocular pressure and glaucoma progression: results from the Early Manifest Glaucoma Trial. Arch Ophthalmol. 2002;120:1268–1279. - PubMed
    1. AGIS Investigators The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol. 2000;130:490–491. - PubMed
    1. Lichter PR, Musch DC, Gillespie BW, Guire KE, Janz NK, Wren PA, et al. CIGTS Study Group. Interim clinical outcomes in the Collaborative Initial Glaucoma Treatment Study comparing initial treatment randomized to medications or surgery. Ophthalmology. 2001;108:1943–1953. - PubMed
    1. Miglior S, Torri V, Zeyen T, Pfeiffer N, Vaz JC, Adamsons I. Intercurrent factors associated with the development of open-angle glaucoma in the European glaucoma prevention study. Am J Ophthalmol. 2007;144 (2:266–275. - PubMed

Publication types