Age at Diagnosis, Asymmetry of Visual Field Loss and Risk Factors in Pigmentary Glaucoma

Abstract

Purpose: : To evaluate:I. Mean age at diagnosis (AAD) and AAD in decades in patients with pigmentary glaucoma (PG).II. Whether PG patients with glaucoma (GL) in family history (FH) show earlier AAD and higher maximum intraocular pressure (IOPmax).III. Whether there is any difference in the symmetry of VFL in PG when comparing with patients with a diagnosis of normal tension glaucoma (NTG) and primary open angle glaucoma (POAG).IV. Whether VFL and IOPmax are correlated in patients with PG.

Methods: : Refractive error, stage of VFL, IOPmax and GL in FH were assessed in 118 patients with PG. Stage of VFL was assessed in 132 patients with POAG and 231 patients with NTG. Pearsons test and Wilcoxon test were used for statistical evaluation.

Results: : Mean AAD was 43.4 ±13.3 years and 39.8±13.1 years for preperimetric PG, respectively. PG was diagnosed before the age of 30 in 20.5% of patients. IOPmax was significantly associated with stage of VFL (p=9.72e-05). Patients with earlier diagnosis had a significantly higher IOPmax (p=0.00061). Patients with GL in FH did not show more severe VFL (p=0.48), did not show an earlier AAD (p=0.099) but had significantly higher IOPmax (p=0.00056) than patients without GL in FH.The degree of symmetry of VFL was significantly higher in patients with PG (p=0.017) when compared to patients with POAG but did not differ from patients with NTG.

Conclusions: : There is a significant association between GL in FH and IOPmax. PG has a high symmetry of VFL corresponding to a high symmetry of IOPmax. Higher IOPmax leads to a significant earlier diagnosis. We propose that IOP is the predominant factor in the pathogenesis of PG.

Keywords: clinical (human) or epidemiologic studies: risk factor assessment