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J. L. Ferreira, J. M. F. Furtado, A. S. Santos, E. M. Rocha, M. L. Veronese Rodrigues, J. S. Paula; Low Persistence as a Risk Factor for Blindness in Patients With Open-Angle Glaucoma Followed Up for at Least 15 Years. Invest. Ophthalmol. Vis. Sci. 2010;51(13):195.
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To determine the proportion of patients experiencing blindness and investigate the relationships between risk factors based on the clinical characteristics and development of blindness in patients with primary open angle glaucoma (POAG) treated for more than 15 years.
A retrospective observational case series was performed with 53 patients referred to a tertiary level hospital in Brazil, each with a diagnosis of POAG made in 1974 or later. Information acquired from the charts of all patients treated for at least 15 years were used. Variables considered to be possible risk factors for unilateral or bilateral blindness were evaluated using odds ratio (OR), confidence interval (95% CI), and univariate and multivariate analyses.
Thirty-one patients became blind (24.5% - unilaterally and 34% - bilaterally) during the follow-up period of treatment (19.5±4.6 years, range 15-31 years). Ten patients (15.4%) were blind in at least one eye from POAG at their first visit. Regression analysis revealed that persistence of the initial therapy ≤ 6 months was significantly associated with blindness, both unilateral (OR: 8.4; 95% CI: 1.3-56.4) and bilateral (OR: 7.2; 95% CI: 1.3-39.6). Other potential factors, such as race, age, gender and number of medications, were not statistically associated with blindness.
Blindness from POAG was not uncommon in this population of treated patients after such a long follow-up period. Persistence rates with the first therapy, as measured by a medical decision to change, were low. Persistence ≤ 6 months was statistically associated with the development of blindness from glaucoma.
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