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Stefano Gandolfi, Daniela Paoli; BRIDGING THE MAJOR CLINICAL TRIALS AND EVERYDAY CLINICAL PRACTICE: CENTRAL CORNEAL THICKNESS AND VISUAL FIELD DAMAGE ARE INDEPENDENT RISK FACTORS FOR PROGRESSION IN A 6-YEAR RETROSPECTIVE EVALUATION OF PATIENTS' ELECTRONIC CHART RECORDS. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3516.
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© ARVO (1962-2015); The Authors (2016-present)
to evaluate risk factors for progression in a population of open angle glaucoma patients routinely followed up in a Hospital-based Glaucoma Clinic
The records of 256 eyes (132 patients) routinely followed in the years 2004-2010 in the Glaucoma Clinics of Parma and Monfalcone were retrospectively evaluated. The data were recorded by using the software Glaucoma Management System 3 © and were sorted by applying a query for eyes with (a) at least one visual field test / year HFA 24/2 SITA, (b) two IOP readings/year , (c) open angle on gonioscopy , (d) a central corneal thickness (CCT) evaluation before being started on therapy and (e) a minimum follow up of six years. Visual field damage was staged by using Brusini’s Glaucoma Staging System 2 (GSS2). Worsening by 1 stage/10 years (i.e. 0.6 of a stage in 6 years) was considered to be significant to label an eye as “progressing”
52/256 eyes (48/132 patients) met the criteria for progression. Mean rate of progression was 0.96 dB/year , meanwhile those eyes, who did not meet the criteria for progression, showed a 0.08 dB/year . Baseline IOP ranged between 21 and 32 mmHg. IOP during follow up ranged between 12 and 23. Mean IOP during follow up was 17.8 mmHg in the non-progressing and 18.2 in the progressing cohort (p > 0.2, unpaired two-tailed Student t test). The eyes were further stratified according to CCT: (a) < 510 micron, (b) between 510 and 550 micron, (c) > 550 micron. The percentage of progressing eyes among the three categories of CCT readings were 57% in (a), 45% in (b) and 10% in (c). A multivariate analysis (SPSS12) dissected, as independent risk factors for progression, (a) CCT< 550 micron (OR 1.8-6.2, p < 0.0001) and (b) baseline MD > 4 dB (2.75% risk / 0.1 dB, p < 0.001)
This “everyday data set “ confirmed that CCT < 550 micron and a Mean Defect > 4 dB can be considered as independent risk factor for progression in treated open angle glaucomas over a 6-year interval.
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