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Eugenia I. Abusleme, Jimena Schmidt, Sylvia Araneda, Carlos Prada, Ximena Maul, Claudio Perez, Eugenio Maul D.; Visual Field Progression In Glaucoma Patients Under Treatment. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4160.
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© ARVO (1962-2015); The Authors (2016-present)
Determine Visual Field Progression (VFP) in open angle glaucoma patients treated in the Glaucoma Department, in a University Medical Center.
Retrospective chart review of patients diagnosed with Primary Open Angle Glaucoma (POAG), Normal Tension Glaucoma (NTG), Pseudoexfoliative Glaucoma (PXEG) and Pigmentary Glaucoma (PG), controlled in our Departament and had at least 5 Sita Standard 24-2 VF tests from 2000 to 2010. VFP was determined in decibels per year (dB/year) with Glaucoma progression analysis (GPA).
160 eyes of 140 patients were included. Mean age was 72.3 years, 69.38% were females. POAG in 66.25%, NTG in 20.63%, PXEG 7.5% and PG in 5.63%. Mean follow up time was 65.22 months, mean number of VF was 8.4. The mean IOP during the period of study was 14.16 ±2.79 mmHg.The mean initial MD was -6.97 dB and the mean final MD was -9.08 dB for the whole cohort. The rate of VFP was -0.39 dB/y. Thirty-one eyes (19.4%) of 28 patients (17.5%) progressed in rate ≥0.8 dB/y during the study period. These patients were considered fast progressors (at least 1 eye with ≥0.8 dB/y). VFP in these eyes was -1.41 dB/y, a rate significantly higher than whole cohort, p=0.00).
In glaucoma care, many patients do progress, but only some of them threatening their visual function. In this group of apparently well controlled glaucoma patients, 19.4% of the eyes lost more than 0.8 db/year. Using these criteria 17.5% of patients were fast progressors. To prevent glaucomatous disability or blindness, enough visual fields are needed to identify fast progressors as soon as possible. These eyes need a more aggressive treatment to avoid blindness. Identifying the fast glaucoma progressors represents a priority and a new paradigm in our clinical decisions.
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