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M. A. Czudowska, R. C. W. Wolfs, A. Hofman, P. T. V. M. de Jong, J. R. Vingerling, N. M. Jansonius; Incidence of Glaucomatous Visual Field Loss: A Ten-Year Follow-Up From the Rotterdam Study. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3082.
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To determine the 10-year incidence of glaucomatous visual field loss (GVFL) in a population-based setting and to study the influence of presumed risk-factors of open-angle glaucoma on this incidence.
Participants at risk of developing GVFL underwent identical ophthalmic examinations (including intraocular pressure [IOP] measurement, visual field testing, optic disc assessment and refraction) at baseline (1990-1993) and during two follow-up visits (1997-1999 and 2002-2004). The incidence of GVFL was determined as an incidence rate and recalculated to a 5-year risk. Presumed risk factors, age, gender, family history of glaucoma, baseline IOP (adjusted for treatment), myopia and baseline vertical cup-disc ratio, were assessed using Cox regression. Dependent variable was the development of GVFL during follow-up.
3939 participants completed at least one follow-up examination; 108 developed GVFL. The overall incidence rate and 5-year risk of GVFL were 2.9/1000 person-years and 1.4% respectively. The 5-year risk increased from 1.0% at age 55 to 59 years to 3.2% at age 80 years and older (P<0.001). Men had a higher incidence than women (Hazard Ratio 1.61; 95% confidence interval 1.10-2.38). The incidence increased by 11% per mmHg increase in IOP (1.11; 1.06-1.15). High (spherical equivalent -4 D or more myopic) myopia (2.28; 1.17-4.44) and a vertical cup-disc ratio above the 97.5th percentile at baseline (4.57; 2.65-7.90) were associated with the development of GVFL. Family history was not significantly associated with the development of GVFL (1.57; 0.92-2.69).
The development of GVFL was related to higher baseline IOP, older age, high myopia, male gender and a larger baseline cup-disc ratio.
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