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Maxime Delbarre, Jean-Marie Giraud, Florent Aptel, Hussam El Chehab, Jean-Remi Fenolland, Marie Maréchal, Anne-Florence Marill, Franck May, Jean-Paul G Renard; Evaluation of visual function in ocular hypertension: PROG-F3 study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5632.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose of this multicentric study is to analyze progression of visual field indices of patients treated for ocular hypertension (OHT).
This prospective study concerned 23.5% of a multicentric cohort (104 eyes of 441). These eyes were monitored and treated for OHT followed up at least 9.7+/-1.65yrs. Every patients underwent every 6 months a complete eye examination and a reproducible visual field testing (Humphrey Field Analyser, SITA-Standard 24-2, Carl Zeiss Meditec) to eliminate any other ocular pathology. At the end of follow-up, patients who developed a POAG were included in evolutive group and patients without functional or structural deficits were considered stable. The following parameters were analyzed: MD, VFI and their rate of progression. Statistical analysis compared populations by a Student t-test and a diagnostic performance was assessed by sensitivity (Se), specificity (Sp) and area under receiver operating characteristic curve (AUROC) of all parameters.
Evolutive group included 46 eyes (44.2%) and stable group included 58 eyes (55.7 %). Rate of progression of MD (dB/yr) for stable and evolutive groups were respectively -0.007 (95%CI [-0.024 ; 0.011]) and -0.285 (95%CI [-0.361 ; -0.209]) (p <0.001). Rate of progression of VFI (%/yr) for stable and evolutive groups were respectively -0.026 (95%CI [-0.042 ; -0.009]) and -0.407 (95%CI [-0.627 ; -0.187]) (p=0.001). Initial MD (dB) at beginning of follow up for stable and evolutive groups were 1.139 (95%CI [0.997 ; 1.313]) and 0.616 (95%CI [0.488 ; 0.744]) (p<0.001). Initial VFI (%) were 99.793 (95%CI [99.675 ; 99.911]) and 99.304 (95%CI [99.098 ; 99.511]) (p<0.001). AUC were, respectively, for MD and VFI rate of progression and MD, VFI indices : 0.966, 0.827, 0.731, 0.702. The cut off value of AUROC were respectively for MD rate of progression, for VFI rate of progression, for MD, and VFI and: -0.100 dB/yr indices (Se=93.5%, Sp=91.4%), -0.143 %/yr (Se=54.3%, Sp=98.3%), 1.02 dB (Se=89.1%, Sp=50.0%) and 99% (Se=81.0%, Sp=58.7%).
MD and VFI rate of progression in OHT evolutive group were higher than in group of patients remained stable. This study reports a higher diagnostic power for MD rate of progression with a cut off of -0.1 dB/year. It could be used to screen OHT patients at risk of POAG. These preliminary results must be completed by further analysis in this multicenter study.
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