Baseline Risk Factors for Glaucoma Predict the Fast Component of the Visual Field Rate of Progression

Abstract

 

Purpose:

 

To investigative the baseline risk factors associated with visualfield (VF) progression in glaucoma with a classification forthe visual field rate fast progressors.

 

Methods:

 

Clinical visual field (VF) predictive factors, previously foundto be associated with increasing the odds of visual field progression,were collected from a cohort of 389 eyes of patients with primaryopen angle glaucoma (Figure 1). A recently described method(ARVO 2010) calculates the VF exponential rate of progressionor decay for each point location and partitions the rates intoits fast and slow components for each eye. Those patients witha fast rate of decay of 20% / year were designated as fast progressors.Using a logistic regression model with these covariates, wepredict those patients who are designated as fast progressorsand determine the predictive risk associated with this VF worsening.

 

Results:

 

The logistic and stepwise logistic regression analysis for themodel predicting eyes as fast progressors (n=118, mean age =67.2 +/- 8.1 years) is shown in Figure 2. The most significantpredictors at baseline for determining the fast progressorswere: Age: Odds ratio: 1.05; 95% CI: 1.02-1.08 (p<.001) AGISscore: Odds ratio: 1.09; 95% CI: 1.04-1.15 (p<.01) Verticaldisk cup ratio: Odds ratio: 7.4; 95% CI: 1.44 - 38.1 (p<.05)

 

Conclusions:

 

Increased vertical cup/disc ratio had the highest associationfor classifying the VF fast progressors as defined by VF worseningby 20%/year. Both increasing age and AGIS score were marginallyassociated with this classification.  

 

 

Keywords: visual fields