Progression of visual field in patients with primary open-angle glaucoma: The Study PROG-F 2 . Levels of progression

Abstract

 

Purpose

 

From a multicentric database, to analyze Mean Deviation (MD) and Visual Field Index (VFI) rates of progression, of non evolutive and evolutive patients with treated ocular hypertension (OHT) or primary-open angle glaucoma (POAG).

 

Methods

 

441 eyes of 228 patients with treated OHT or POAG followed up at least 5 years (mean=8.4 years) with Humphrey 24.2 Sita-Standard VF exam at least twice a year were identified and classified in 5 groups: 104 OHT, 205 early glaucoma (MD>-6dB), 45 moderate glaucoma (MD-6 to -12dB), 41 advanced glaucoma (MD-12 to -18dB) and 46 severe glaucoma (MD<-18dB). With final datas, patients were classified in 2 sub groups: “evolutive” or “stable” patients if worsening or not to upper grade. Rate of progression during follow-up period was calculated using the trend analysis of the Guided Progression Analysis software.

 

Results

 

See table below

 

Conclusions

 

MD and VFI progression rates are clearly lower in OHT (‘stable’ and ‘evolutive’) groups than in POAG. In early, moderate and advanced POAG, supposed ‘stable’ patients, MD progression rate is around -0.1dB/year, similar to results of prior published studies with smaller populations. In the 3 supposed ‘evolutive’ patients subgroups, MD rates of progression are very close, with a significant difference from ‘stable’ populations. VFI’s progression rates are higher in the most advanced grades of POAG. Patients categorised in high grades of glaucoma at inclusion in the study may have a quicker progression In OHT, patients with progression rate higher than -0.28dB/year for MD or -0.41%/year for VFI have big risk to progress to glaucoma. In glaucoma patients, progression rates higher at -0.8dB/year for MD, -2.5%/year for VFI could be good marker of evolutive glaucoma.

 

 

Keywords: 758 visual fields • 642 perimetry