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M. T. Nicolela, B. C. Chauhan, A. Belliveau, G. P. Sharpe, P. H. Artes; Rates of Visual Field Progression in Glaucoma Patients With Different Optic Disc Phenotypes. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4019.
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To compare visual field progression in a cohort of glaucoma patients with distinct optic disc phenotypes.
136 open-angle patients with glaucoma were enrolled after their study eye was classified as having one of three optic disc phenotypes (focal, diffuse, or sclerotic optic disc damage appearance). Patients were followed every 4 months, with a variety of tests performed at each visit, including visual field tests (24-2 SITA standard test). Patients were treated with topical, laser, or surgical therapy necessary to achieve a target intraocular pressure determined at baseline. In this report, we evaluated visual field progression in all patients who had at least 5 tests available for analysis. The rate of mean deviation (MD) change was evaluated by trend analysis.
132 eyes from 132 patients qualified for this analysis (45 eyes with focal, 43 eyes with diffuse and 44 eyes with sclerotic optic disc phenotypes). Mean (SD) age for patients in the three groups was 69 (12), 64 (11) and 72 (9) years respectively. Mean (SD) follow-up for all patients was 43.7 (8.2) months, similar in the three groups. Baseline mean MD (SD) was -6.6 (5.2) dB, -3.7 (3.8) dB and -4.0 (3.3) dB in eyes with focal, diffuse and sclerotic loss respectively (p=0.001). There was a significant difference in the rates of MD change from the three groups, showing that eyes with diffuse optic disc damage progressed more slowly than eyes with focal or sclerotic disc damage, (Table 1, p<0.011, Kruskall-Wallis).
This study showed different rates of progression in patients with distinct optic disc phenotypes followed in a prospective study. Eyes with focal damage had the greatest rates of visual field progression, whereas eyes with diffuse optic disc damage had the lowest.
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