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Youngkyo Kwun, Gyule Han, Yoon-Jung Choy, Changwon Kee; Factors predicting the rate of visual field progression in normal-tension glaucoma eyes with tilted disc. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5610.
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To evaluate the factors predicting the rate of visual field(VF) progression in normal-tension glaucoma eyes with tilted disc.
Fifty-one eyes of 28 NTG patients with tilted disc were included in this study. All subjects with an average follow-up period of 100.1 ± 49.3 months evaluated with Spectral-Domain Optical Coherence Tomography(SD-OCT), static automated perimetry, color optic disc stereo photography and comprehensive ophthalmologic examinations. Optic disc ovality was defined by the ratio of minimum to maximum disc diameter. The lamina cribrosa thickness and prelaminar depth were measured using B-scan images of SD-OCT. The VF progression was determined by serial visual field data and all eyes were classified as rapid progression group and slow progression group according to rate of VF index decline over time(-0.5%/year). Statistical analyses were performed using Mann-Whitney U test and linear regression analysis.
Twenty-six eyes were classified as rapid progression group. The mean rate of VF index decline over time were -1.96 ± 1.72 %/year in rapid progression group and -0.06 ± 0.41 %/year in slow progression group. There were no difference in the age, initial and last intraocular pressure, central corneal thickness, follow-up period, laminar cribrosa thickness and prelaminar depth among two groups. The rapid progression group showed higher initial mean deviation(P<0.01), higher initial pattern standard deviation(P<0.01) and greater optic disc ovality.(P=0.04) In linear regression analysis, optic disc ovality showed a significantly correlation with the rate of VF progression.(P<0.01)
The increased optic disc ovality was associated with rapid rate of VF progression in NTG eyes with tilted disc. Therefore, the optic disc ovality should be considered for the treatment of NTG eyes with tilted disc.
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