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Koji Nitta, Ryotaro Wajima, Gaku Tachibana, Sachie Inoue, Ryuta Fujiwara, Kazuhisa Sugiyama; Analysis of Risk Factors for Visual Field Progression in Open Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2607.
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© ARVO (1962-2015); The Authors (2016-present)
Glaucoma is considered to be a multifactorial disease, but the risk factors have not been determined. This study is a large-scale longitudinal retrospective study, evaluating the risk factors in Japanese patients with primary open angle glaucoma (POAG) and normal tension glaucoma (NTG).
The data used in this study was obtained from 498 eyes of 312 patients examined by the same glaucoma specialist at Fukui-Ken Saiseikai Hospital from June 2009 to May 2015. Data analysis was conducted for 452 eyes of 290 patients (Male:Female = 282:170, mean age: 60.1±10.5, POAG:NTG = 54:398) with over six reliable visual field (VF) examinations. The relationship between mean deviation (MD) slope and the baseline or the clinical findings was evaluated using correlation analysis (numerical parameter), t-test or analysis of variance (non-numerical parameter). This study was approved by the institutional review board, and patients were provided the opportunity to disclaim the use of their information.
The mean untreated intraocular pressure (IOP) was 16.3±4.3 mmHg. The mean MD and the mean nerve fiber layer defect (NFLD) angle at the baseline was -6.86±6.19 dB and 35.5±29.1, respectively. The NFLD was observed in 82.6% of the patients. The mean IOP and the MD slope during observation period was 12.8±2.0 mmHg and -0.23±0.46 dB/year, respectively. The frequency of the patients with disc hemorrhage (DH) during observation was 29.6%. In the baseline, the presence of DH (P<0.001), the pattern standard deviation (PSD) (r=-0.243, P<0.001), the rim width (r=0.220, P<0.001), and the vertical cup to disc ratio (v C/D) (r=-0.216, P<0.001) was significantly correlated with the MD slope. In the parameters obtained from the observation period, the frequency of DH (r=-0.204, P<0.001) and the rate of NFLD angle enlargement (r=-0.159, P=0.007) also significantly correlated with the MD slope.
The presence and frequency of DH, the thinning of the rim width, the increase of PSD, v C/D and rate of NFLD angle enlargement seem to be risk factors in Japanese patients with open angle glaucoma highly involving NTG patients. These results suggest that NTG patients frequently found in Asia have different risk factors (such as DH) compared with POAG patients. Careful follow-up procedure should be necessary for patients with these risk factors.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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