April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
The Role of Age and Ocular Perfusion Pressure in Determining Visual Field Progression of Glaucomatous Patients
Author Affiliations & Notes
  • Melanie A. Pickett
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Alon Harris
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Brent A. Siesky
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Yochai Z. Shoshani
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Aaron A. Cohen-Gadol
    Neurosurgery,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Leslie Abrams
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Darrell WuDunn
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Chi-Wah R. Yung
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • John Abrams
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Mohammadali Shoja
    Ophthalmology,
    Indiana University Sch of Medicine, Indianapolis, Indiana
  • Footnotes
    Commercial Relationships  Melanie A. Pickett, None; Alon Harris, Pfizer Pharmaceuticals (C); Brent A. Siesky, None; Yochai Z. Shoshani, None; Aaron A. Cohen-Gadol, None; Leslie Abrams, None; Darrell WuDunn, Pfizer (R); Chi-Wah R. Yung, None; John Abrams, None; Mohammadali Shoja, None
  • Footnotes
    Support  Unrestricted grant from Research to Prevent Blindness and Pfizer Pharmaceuticals
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 3476. doi:
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      Melanie A. Pickett, Alon Harris, Brent A. Siesky, Yochai Z. Shoshani, Aaron A. Cohen-Gadol, Leslie Abrams, Darrell WuDunn, Chi-Wah R. Yung, John Abrams, Mohammadali Shoja; The Role of Age and Ocular Perfusion Pressure in Determining Visual Field Progression of Glaucomatous Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3476.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To assess the effect of age and ocular perfusion pressure on visual field progression in patients with open angle glaucoma (OAG).

Methods: : 103 patients (age 67.1, 59 female) enrolled in the Indianapolis Glaucoma Progression Study were evaluated at baseline and 1.5 years follow up. Central corneal thickness (CCT) was measured by ultrasonic corneal pachymeter. Ocular perfusion pressure (OPP) was calculated as OPP=2/3(mean arterial pressure)-intraocular pressure (IOP). Retinal structural measurements were made using ocular coherence tomography (OCT). Visual fields were assessed by Humphrey Visual Field Analyzer (24-2 SITA standard). Changes in visual fields and its predictability by baseline retinal structural features, age, gender, CCT, OPP and initial AGIS score were evaluated. Bivariate correlations coefficient was estimated by Spearman rank correlation test. To assess the independent contributions of age, gender, initial OPP, CCT, AGIS score and OCT parameters to AGIS score changes, multivariate regression analysis with rank-transformed data was used to obtain the partial correlation coefficients.

Results: : Changes in AGIS score positively correlated with baseline cup area (r=0.214, P=0.030), cup/disc area ratio (r=0.219, P=0.026), cup/disc horizontal and vertical ratios (r=0.218, P=0.027 and r=0.231, P=0.019, respectively) and macular center (r=0.207, P=0.036). Changes in AGIS score negatively correlated with vertical and horizontal rim width and rim area. Multivariate linear regression model revealed that AGIS score change was negatively associated with baseline rim area (partial rho= -0.253, P= 0.014) independent of age, gender, OPP, CCT and initial AGIS score. In patients less than 70 years (n= 54), only the baseline rim area was an independent predictor of AGIS score changes (partial rho= -0.338, P= 0.022). However, in patients 70 years or older (n= 49), only OPP was an independent predictor of AGIS score changes (partial rho= 0.325, P= 0.034).

Conclusions: : In OAG patients less than 70 years of age, baseline optic nerve head structure may be the main determinant of early glaucomatous visual field loss. However, in OAG patients older than 70 years, OPP may be more important in predicting visual field progression.

Keywords: aging: visual performance • aging • visual fields 
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