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Jun Mo Lee, Joseph Caprioli, Kouros Nouri-Mahdavi, Abdelmonem Afifi, Esteban Morales, Meera Ramanathan, Fei Yu, Anne Coleman; Baseline Prognostic Factors Predict Rapid Progression. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3487.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate baseline prognostic factors which predict rapid progression of the visual field (VF) in primary open angle glaucoma patients.
767 eyes of 566 subjects from the Advanced Glaucoma Intervention Study (AGIS) and the University of California at Los Angeles’ (UCLA) Jules Stein Eye Institute with primary open angle glaucoma were included. The VF rate of decay for each VF test location was calculated with point-wise exponential regression (PER) analysis and separated into fast and slow components. Subjects with a fast component decay rate of 36%/year or faster were designated as rapid progressors. See Table 1 for prognostic factors assessed in the multiple regression model. For cross-validation of our logistic model, we developed a sampling group containing 2/3 of the entire study group and identified the rapid progressors to which we fitted the same logistic model. We obtained the coefficient estimates and applied them to the 1/3 test group. We calculated the probability of being a rapid progressor for each eye in the test group and calculated the area under curve (AUC) of the receiver operating characteristic curve (ROC). After repeating this procedure 1,000 times, we calculated the average AUC as cross-validation for the model.
222 eyes were identified as rapid progressors. The average (±standard deviation) age was 65.93(±9.9) years in the rapid progressors. Subjects with worse baseline MD (P<0.0001; odds ratio[OR], 1.12; 95% confidence interval[CI], 1.09 to 1.16), greater vertical C/D ratio at baseline (P=0.001; OR, 1.23; 95% CI, 1.09 to 1.39), and older age at baseline (P=0.030; OR, 1.23; 95% CI, 1.02 to 1.49) were more likely to have a fast VF component rate of 36%/year or faster than did subjects without these characteristics.
Worse baseline MD had the highest association for classifying the rapid progressors as defined by the VF fast component worsening by 36%/year. Both increasing baseline vertical C/D ratio and increasing age at baseline were also associated with this classification.
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