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Yusuke Manabe, Hiroko Inuzuka, Akira Sawada, Tetsuya Yamamoto; Long-term clinical course of normotentive preperimetric glaucoma.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1055.
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To evaluate the long-term clinical course of normotensive preperimetric glaucoma (PPG).
We retrospectively investigated 65 eyes of 65 patients diagnosed initially as preperimetric normal tension glaucoma (NTG) between 1985 and 2006, and followed for at least 5 years with having reliable visual field examinations by standard automated perimetry (program central 30-2) more than 10 times. We reviewed the patients’ data including best corrected visual acuity and visual field from our records. At their latest consecutive two visual field examinations the patients without glaucomatous visual field defect, which was judged by the Anderson’s criteria, were excluded. A normal visual field was judged at three initial baseline examinations. When the visual field defect met the Anderson’s criteria at least two consecutive examinations and the results at following examinations are quite consistent, the eye was classified as developing a glaucomatous visual field defect.
The mean age at diagnosis was 52.4 ± 11.4 years with a range of 16 to 73 years. Men were 25 and women were 40. The mean follow-up period was 16.1 ± 5.6 years with a range of 7 to 26 years. Seven eyes had no ocular hypotensive drugs at their final visits and 2 eyes patients had received glaucoma surgery during the follow-up period. The mean period to development of glaucomatous visual field loss from their diagnosis was 6.8 ± 4.1 years with a range of 0.6 to 16.0 years. The mean deviation slope (MD slope) was -0.22 ± 0.27 dB/year with a range of -0.93 to 0.25 dB/year. There was a statistically significant visual filed defect deterioration in 38 eyes (58.5%).
Approximately half of initially preperimetric NTG showed significant visual filed loss progression during a mean follow-up of 16 years. However, the rates of visual field loss progression varied considerably among individuals.
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