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Hohberger Bettina, Folkert Horn, Anselm Junemann, Robert Laemmer; Longitudinal analysis of Glaucoma Suspects from the Erlangen glaucoma registry (EGR): Influence of neuroretinal rim area and visual field indices on Progression. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3945.
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The aim of this study was to investigate the long-term follow up of glaucoma suspects, recruited from the Erlangen glaucoma registry to detect parameters, indicating disease progression. For this purpose visual fields and the neuroretinal rim area (quantified with the HRT) were compared between two cohorts: with and without perimetric progression.
329 glaucoma suspect eyes were included (177 OHTs, 152 preperimetric open angle glaucomas, preOAG). All patients are members of the Erlangen glaucoma registry (ISSN 2191-5008, CS-2011) for 8 to 20 years. The clinical database (NCT00494923) allows longitudinal observation of exactly defined glaucoma patient groups over two decades. The protocol was approved by the Local Ethics Committee (3457). All had annual complete ophthalmological examinations, including Octopus (protocol G1) and HRT. In our study, information from 5 years of consecutive clinical-instrumental evaluation of the glaucoma suspects separated 2 groups: Patients without and with glaucoma progression. Progression was defined using perimetric event analysis, confirmed at least once. In order to investigate the progress per year individually, linear regression analyses were done using 6 data sets before progression occurred. In the non-progressive group, the most recent 5 years were evaluated. In addition, annual results were compared with t-test (alpha = 0.05).
38 (11,5 %; 5 OHT; 22 preOAG) of the total cohort showed perimetric glaucoma progression. This progressive group showed significant higher MD as the non-progressive group at baseline of the present observation period. SLV was higher in the progressive group at all time-points of examinations. This difference reached level of significance 2 years before visual field losses occurred. The area of the neuroretinal rim was significant different between both subgroups 5 years before perimetric field defects occurred, with no significant decrease in the course.
Findings in the present ‘suspect’ cohort of the EGR show the prognostic value of an increasing sLV for conversion to ‘perimetric‘ glaucoma. Therefore, reduced area of neuroretinal rim values and elevated sLV must be considered as indicators for glaucoma progression.
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