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Editorial
. 2025 May 31;17(5):e85129.
doi: 10.7759/cureus.85129. eCollection 2025 May.

From Velocity to Acceleration: A Perspective on Age-Related Visual Field Progression in Glaucoma

Masaki Tanito  1 , Tomoki Shirakami  1
Affiliations
Editorial

From Velocity to Acceleration: A Perspective on Age-Related Visual Field Progression in Glaucoma

Masaki Tanito et al. Cureus. .

Abstract

The conventional evaluation of visual field (VF) progression in glaucoma often relies on linear regression to estimate the rate of decline, focusing on velocity (dB/year). However, this approach may underestimate future progression, particularly in elderly patients. This editorial highlights the importance of incorporating acceleration (dB/year²) into clinical assessments of VF loss. Using physiological and pathological models, we demonstrate that VF sensitivity decline is inherently nonlinear with age. A cubic model illustrates age-related sensitivity loss in healthy eyes, while a quadratic model captures the interaction between disease duration and baseline age in glaucomatous eyes. These models emphasize that progression accelerates over time and suggest that individualized treatment intensity should consider not only the current rate of VF decline but also its likely acceleration based on patient age and disease course.

Keywords: acceleration; aging; glaucoma; nonlinear modeling; visual field progression.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Age-related decline in VF sensitivity in normal eyes, based on Spry and Johnson's cubic model.
(A) Projected lifelong trajectory of VF sensitivity for a baseline age of 20 years. (B) Projected 25-year trajectories of VF sensitivity for baseline ages of 35, 45, 55, 65, and 75 years. VF: visual field Reference: [12]
Figure 2
Figure 2. Age-related VF decline in glaucomatous eyes derived from the Shirakami et al. quadratic model.
(A) Projected lifelong trajectories of VF sensitivity (starting MD = 0 dB; baseline age = 20 years). (B) Projected 25-year trajectories of VF MD in glaucomatous eyes starting from −10 dB for baseline ages of 35, 45, 55, 65, and 75 years. VF: visual field; MD: mean deviation Reference: [13]
See this image and copyright information in PMC

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