April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Effect of Treatment on Rates of Visual Field Change in the Ocular Hypertension Treatment Study
Author Affiliations & Notes
  • C. G. De Moraes
    Ophthalmology, New York University School of Medicine, New York, New York
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
  • S. Demirel
    Devers Eye Institute, Legacy Health, Portland, Oregon
  • S. K. Gardiner
    Devers Eye Institute, Legacy Health, Portland, Oregon
  • J. M. Liebmann
    Ophthalmology, New York University School of Medicine, New York, New York
  • G. A. Cioffi
    Devers Eye Institute, Legacy Health, Portland, Oregon
  • R. Ritch
    Ophthalmology, New York Eye & Ear Infirmary, New York, New York
  • M. O. Gordon
    Ophthal & Vis Sciences, Washington Univ Sch of Med, St Louis, Missouri
  • M. A. Kass
    Ophthal & Vis Sciences, Washington Univ Sch of Med, St Louis, Missouri
  • Ocular Hypertension Treatment Study
    Ophthalmology, New York University School of Medicine, New York, New York
  • Footnotes
    Commercial Relationships  C.G. De Moraes, None; S. Demirel, None; S.K. Gardiner, None; J.M. Liebmann, Optovue, Inc., C; Pfizer Inc., C; Topcon Medical Systems, Inc., C; Carl Zeiss Meditec, Inc., F; Diopsys, Inc., F; Heidelberg Engineering, GmbH, F; Optovue, Inc., F; Topcon Medical Systems, Inc., F; Reichert, F; Alcon Laboratories, Inc., C; Allergan, Inc., C; Diopsys, Inc., C; G.A. Cioffi, None; R. Ritch, Carl Zeiss Meditec, Inc., F; Diopsys, Inc., F; Heidelberg Engineering, GmBH., F; Topcon, Inc., F; Reichert, Inc., F; Alcon Laboratories, Inc., C; Allergan, Inc., C; Danube Pharmaceuticals, Inc., C; Pfizer Ophthalmics, Inc., C; M.O. Gordon, None; M.A. Kass, None.
  • Footnotes
    Support  NIH EY09307, EY09341; NCMHD; Merck; Pfizer; Research to Prevent Blindness; Gildor Research Fund; Glaucoma Research and Education fund of Lenox Hill Hospital; Legacy Good Samaritan Foundation.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 2049. doi:
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      C. G. De Moraes, S. Demirel, S. K. Gardiner, J. M. Liebmann, G. A. Cioffi, R. Ritch, M. O. Gordon, M. A. Kass, Ocular Hypertension Treatment Study; Effect of Treatment on Rates of Visual Field Change in the Ocular Hypertension Treatment Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2049.

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

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Abstract

Purpose: : To assess the effect of treatment on rates of global [Mean Deviation (MD)] and local visual field change in the OHTS.

Methods: : MD and pointwise thresholds from OHTS subjects originally randomized to observation were examined before and after initiation of topical ocular hypotensive medication. The analysis dataset included eyes with ≥5 reliable visual fields covering ≥5 years both pre and post treatment. 677 eyes of 392 participants met these criteria. The rate of change of MD over time [MDR (dB/yr)] was calculated (linear regression) separately for the period before and the period after starting treatment. This exercise was repeated using a subset of eyes that reached a POAG endpoint (n=239) but the minimum follow-up before and after starting treatment was relaxed to 2.5 years. Pointwise Linear Regression (PLR) was also performed separately pre and post treatment. A difference in MDR and in the number of eyes deemed progressing by PLR (≥1 location changing at least -1.0 dB/yr with p<0.01) across the treatment boundary was sought.

Results: : Average MDR before treatment was -0.07 ± 0.26 and after initiation of treatment was -0.07±0.30 dB/yr. Among POAG endpoint eyes the pre and post treatment values were -0.21±0.54 and -0.24±0.50 dB/yr. None of these pre and post treatment differences in MDR was significant (p=0.9 whole group; p=0.6 POAG subgroup). Applying PLR to the subset of POAG endpoint eyes, 98 eyes progressed before and 95 eyes progressed after treatment (p=0.8).

Conclusions: : These results suggest that any benefit of treatment on the velocity of visual field change in ocular hypertensive and early POAG eyes was not evident when examining MD, perhaps because very few locations are deteriorating. They also suggest that a commonly used PLR criterion may be too strict to capture the effect of treatment on local rates of visual field change in ocular hypertensive or early POAG eyes.

Clinical Trial: : www.clinicaltrials.gov NCT00000125

Keywords: perimetry • visual fields • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials 
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