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Maria Valeria C P Silva, Alberto Diniz-Filho, Sebastiao Cronemberger, Felipe A Medeiros; Cognitive Decline is Associated with Increased Visual Field Variability in Glaucoma. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the relationship between cognitive decline and variability on visual fields in patients with glaucoma and suspected of having the disease followed over time.
The study involved 189 eyes of 105 patients followed for an average period of 2.6 ± 0.7 years. Eighty-three (79%) patients had a diagnosis of glaucoma and 22 (21%) were considered glaucoma suspects. All patients had Montreal Cognitive Assessment (MoCA) questionnaires and standard automated perimetry (SAP) tests during follow-up. Change in cognitive scores was assessed by calculating the difference between MoCA scores at the last follow-up visit from those at baseline. Visual field variability was estimated through the residuals of SAP mean deviation (MD) from linear regression over time. Generalized estimating equations models were used to investigate the relationship between variability on visual fields and cognitive decline, taking into account the correlation between fellow eyes, and also adjusting for potentially confounding factors.
There was a significant correlation between change in MoCA scores and variability in SAP MD. A 5-unit decline in MoCA score was associated with an increase of 0.15 dB in variability of SAP MD during the follow-up period (P=0.002). For comparison, a 10 dB lower SAP MD was associated with an increase of 0.10 dB in variability during the follow-up period (P<0.001). In a multivariable model adjusting for baseline MoCA score, SAP MD, age, gender, race, and number of visits, each 5-unit decline in MoCA score was associated with a change of 0.10 dB in SAP MD during the follow-up period (P=0.023).
Cognitive decline was associated with increased visual field variability during follow-up in patients with glaucoma and suspects.
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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