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Observational Study
. 2019 Jun:202:62-71.
doi: 10.1016/j.ajo.2019.02.015. Epub 2019 Feb 20.

Predictive Factors for the Rate of Visual Field Progression in the Advanced Imaging for Glaucoma Study

Xinbo Zhang  1 , Richard K Parrish 2nd  2 , David S Greenfield  2 , Brian A Francis  3 , Rohit Varma  4 , Joel S Schuman  5 , Ou Tan  1 , David Huang  6 ; Advanced Imaging for Glaucoma Study Group
Affiliations
Observational Study

Predictive Factors for the Rate of Visual Field Progression in the Advanced Imaging for Glaucoma Study

Xinbo Zhang et al. Am J Ophthalmol. 2019 Jun.

Abstract

Purpose: To investigate predictive factors associated with the rate of visual field (VF) loss in open-angle glaucoma.

Design: Prospective multicenter cohort study.

Methods: Perimetric glaucoma patients of the Advanced Imaging for Glaucoma study were selected for analysis if they had 9 completed visits. Confirmed rapid significant progression (CRSP) of VF was defined as a significant (P < 0.05) negative VF index (VFI) slope of -1%/year or a mean deviation slope of -0.5 dB/year, confirmed at 2 consecutive follow-up visits. Slow progression was defined as VFI slope greater than -0.5%/year or a mean deviation slope of -0.25 dB/year. Fourier-domain optical coherence tomography (FD-OCT) measured optic disc, peripapillary retinal nerve fiber layer (NFL), and macular ganglion cell complex (GCC) thicknesses. Logistic regression was used to identify baseline predictors for CRSP and slow progression. Linear regression was used to identify baseline predictors for the VFI and mean deviation slope.

Results: Eyes (n = 150) of 103 participants were included. Slow progression was observed in 80 eyes (53.3%) and CRSP in 23 eyes (15.3%). Larger NFL and GCC baseline focal loss volume (FLV), thinner central corneal thickness, and lower VFI were significant (P < 0.05) baseline predictors of more rapid progression on univariate analysis. The predictor with the highest odds ratio (OR) was NFL-FLV, which was also the most significant non-VF predictor in the multivariate analysis. Eyes with NFL-FLV >8.5% had an OR of 2.67 for CRSP and 0.42 for slow progression. Disc hemorrhage during the follow-up was also important, with an OR of 2.61 for CRSP and 0.23 for slow progression for each occurrence.

Conclusions: Focal loss measured by FD-OCT or VF along with CCT are strong baseline predictors for the rate of glaucoma progression.

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Conflict of interest statement

Financial Disclosure(s): Oregon Health & Science University (OHSU), Dr. Tan, and Dr. Huang have a significant financial interest in Optovue, Inc., a company that may have a commercial interest in the results of this research and technology. These potential conflicts of interest have been reviewed and managed by OHSU.

Figures

Figure 1.
Figure 1.
Venn diagram for the detection of confirmed rapid significant progression by mean deviation (MD) and visual field index (VFI).
Figure 2.
Figure 2.
The probability plot of a logistic model of confirmed rapid significant progression (CRSP) on baseline visual field index with quadratic term (both linear and quadratic terms are significant) and the observed CRSP.
See this image and copyright information in PMC

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