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A. Vaccaro, E. Kim, C. G. V. de Moraes, C. C. Teng, C. Tello, R. Ritch, J. M. Liebmann; Rates of Visual Field (VF) Progression in Pigmentary Glaucoma (PG) and Juvenile Primary Open Angle Glaucoma (JPOAG). Invest. Ophthalmol. Vis. Sci. 2010;51(13):4020.
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To compare the rates of VF progression in treated patients with PG and JPOAG.
The charts of all patients seen in a glaucoma referral practice between 1999 and 2009 were reviewed. Only treated eyes with ≥8 SITA Standard 24-2 VF tests with a diagnosis of PG or JPOAG were included. Age at initial diagnosis, sex, refractive error, central corneal thickness (CCT), baseline VF mean deviation (MD) and IOP were recorded. Eyes with underlying conditions known to affect the VF were excluded. Automated pointwise linear regression analysis determined global and localized rates (dB/yr) of change. A VF series was considered progressing by two criteria: A) sensitive criterion: when at least one point showed a threshold sensitivity decline at a rate of ≥1.0 dB/yr with p<0.01; B) specific criterion: two adjacent points in the same hemifield using the above (A) criteria.
59 JPOAG and 24 PG eyes were enrolled. JPOAG patients were older (47.5±12.0 vs 35.7±9.2 yrs, p<0.01) and more often female (58% vs 38%, p=0.15, but refractive error (-3.6±3.4 vs -4.2±4.0 D, p=0.49), number of VF tests (10.5±3.0 ±11.3±3.1, p=0.27), f/u time (105±47 vs 117±56 months, p=0.3), mean CCT (549.4±39.8 vs 530.5.±41.6 µm, p=0.06), mean IOP (15.4±3.5 vs 14.5±3.2 mmHg, p=0.3), and peak IOP (mean 20.3±4.8 vs 18.9±4.8 mmHg, p=0.23) were similar. In the univariate analysis, PG eyes showed faster global rates of VF change (mean -0.40±0.4 vs -0.20±0.6 dB/yr, p=0.02) and similar localized rates (mean, -2.2±0.7 dB vs -2.0±0.7 dB/yr, p=0.45) compared to JPOAG eyes (Mann-Whitney rank test), but the difference in global rates became non-significant after adjusting for age and CCT (p=0.5, ANCOVA). The numbers of eyes reaching a progression endpoint using both the sensitive (PG, 11/24 vs JPOAG, 18/59, p=0.21) and specific (PG, 7/24 vs JPOAG, 12/59 p=0.39) criteria were statistically similar between groups.
PG and JPOAG share similar epidemiological features (age of onset, myopia) despite different pathogeneses. Yet when treated, both diseases tend to behave similarly regarding rates of VF progression.
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