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Sun Hee Lim, Yeon Ggoch Park, Kyu-Ryong Choi; Longitudinal analysis of progression in Korean patients with normal tension glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2260.
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To evaluate the rate of visual field(VF) progression and changes of retinal nerve fiber layer(RNFL) thickness in Korean patients with normal tension glaucoma(NTG).
One hundred patients(100 eyes) with NTG, who were being treated with topical antiglaucoma drugs and had been followed for more than 2 years, were studied. All subjects were classified into 3 groups by initial mean deviation(MD): early stage with MD of -6dB or better, moderate stage with MD between -6dB and -12dB, and advanced stage with MD of -12dB or worse. Using Glaucoma change probability analysis(STATPAC2), we determined visual field progression and classified 2 groups: progression and non-progression. To estimate the rate of VF progression of half-of-patients, datas were analyzed using Kaplan-Meier survival test. And Linear mixed models were used to estimate the rate of changes in MD(dB/yr) and RNFL thickness(μm/yr) for all subjects.
Forty-two patients were placed in the early stage group, twenty-four into the moderate stage group, and thirty-four into the advanced stage group. There were significant differences in the baseline MD, baseline PSD and mean MD slope among 3 groups. Mean MD slope in the early stage group (-0.29±0.04dB/yr) was significantly steeper than that in other groups (moderate stage; -0.33±0.04dB/yr, severe stage; -0.05±0.08dB/yr). After 7-8 years, half of patients with NTG showed localized progressions in early or moderate stage groups. In progression group(n=35), mean MD slope(-0.41±0.04dB/yr) was significantly steeper than in non-progression group(-0.11±0.11dB/yr). In progression group, the proportion of advanced stage was lower(20%) than other stages. The rate of changes of RNFL thickness was steeper in progression group(-0.97±0.17μm/yr) than non-progression group(-0.43±0.05μm/yr).
The progression rate of visual field defects, MD slope, and RNFL thickness in patients with NTG differed according to the severity of the initial visual field damage. The progression rate of visual field defects was higher in patients with early or moderate stage than in that with advanced stage.
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