April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Progression of Glaucoma in a multicentre cohort of patients
Author Affiliations & Notes
  • Seena Nambiar
    Faculty of Medicine, University of Southampton, Southampton, United Kingdom
    Ophthalmology, Frimley Park Hospital NHS Foundation Trust, Frimley, United Kingdom
  • Angela Cree
    Faculty of Medicine, University of Southampton, Southampton, United Kingdom
  • Jane Gibson
    Centre for Biological Sciences, University of Southampton, Southampton, United Kingdom
  • Sobha Sivaprasad
    Ophthalmology, King’s College Hospital NHS Foundation Trust, London, United Kingdom
  • Aby Jacob
    Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
  • Alex MacLeod
    Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
  • Geeta Menon
    Ophthalmology, Frimley Park Hospital NHS Foundation Trust, Frimley, United Kingdom
  • James Kirwan
    Ophthalmology, Portsmouth Hospitals NHS Trust, Portsmouth, United Kingdom
  • Sarah Ennis
    Faculty of Medicine, University of Southampton, Southampton, United Kingdom
  • Andrew Lotery
    Faculty of Medicine, University of Southampton, Southampton, United Kingdom
    Ophthalmology, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
  • Footnotes
    Commercial Relationships Seena Nambiar, None; Angela Cree, None; Jane Gibson, None; Sobha Sivaprasad, None; Aby Jacob, None; Alex MacLeod, None; Geeta Menon, None; James Kirwan, None; Sarah Ennis, None; Andrew Lotery, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 981. doi:
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      Seena Nambiar, Angela Cree, Jane Gibson, Sobha Sivaprasad, Aby Jacob, Alex MacLeod, Geeta Menon, James Kirwan, Sarah Ennis, Andrew Lotery; Progression of Glaucoma in a multicentre cohort of patients. Invest. Ophthalmol. Vis. Sci. 2014;55(13):981.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To study glaucoma progression in a cohort of open angle glaucoma patients.

 
Methods
 

We conducted a multicentre retrospective database review of patients diagnosed with primary open angle glaucoma (POAG) and normal tension glaucoma (NTG). Data obtained included disease duration (DD), Humphreys visual fields 24-2 (HVF) mean deviation (MD) and cup:disc ratio (CDR). Glaucoma was staged using Hodapp-Parish-Anderson criteria as early(MD≥ -6dB), moderate(MD<-6dB to -12dB) and severe(MD<-12dB). We studied the glaucoma progression in a subset of 30 glaucoma patients equally distributed in 2 groups of 15 each. Both groups were comparable in age. Group1 had early glaucoma and group2 had moderate-severe glaucoma. MD recorded at diagnosis, 3 and 5 years were noted. Pearson correlation and paired t-tests were used for statistical analyses.

 
Results
 

Data obtained for 870 patients included 727 (83.6%) with POAG and 143 (16.4%) with NTG. The mean DD was 8.42 ± 8.34 years. The mean MD in the POAG group was -9.06 ± 7.81 and in the NTG group -7.44 ± 7.11. Independent correlation analysis of POAG and NTG showed there was a statistically significant positive correlation of DD with CDR and negative correlation with MD (n=727, p<0.001, 2-tailed) in the POAG group.This suggests that progression in optic disc cupping and worsening of MD of HVF corresponds to DD. Conversely the NTG group showed no correlation between DD and CDR although a significant negative correlation was noted between DD and MD (n=143, r=-0.316, p<0.001, 2-tailed). In the subset group 1 a mean baseline MD of -2.8 ± 1.66 dB deteriorated by a mean 1.41 ± 1.67 dB (p=0.006), in the initial 3 years and by a mean of 1.46 ± 1.28 dB (p=0.001) in the next 2 years. In group 2 a mean baseline MD -13.46 ± 4.55 dB deteriorated by a mean of 2.69 ± 2.70 dB (p=0.002) in the initial 3 years and thereon by a mean of 1.38 ±2.29 dB (p=0.035).

 
Conclusions
 

Our results suggest that DD correlates well with optic disc and HVF changes in POAG but only with HVF changes in NTG. In our subset we noted the mean deterioration in HVF between baseline and year 3 in group 2 was greater than group 1(although not significant, p=0.3). This may suggest that HVF in advanced glaucoma deteriorate rapidly. This will be evaluated in future studies with larger numbers of patients. The above phenotypic differences may be due to underlying different genetic variants contributing to these phenotypic subsets of open angle glaucoma.

     
Keywords: 758 visual fields • 627 optic disc • 568 intraocular pressure  
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