April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Intraocular Pressure, Baseline Visual Field (VF) Mean Deviation (MD), and Glaucoma Progression
I. Forchheimer; C. G. De Moraes; F. A. Folgar; C. C. Teng; C. Tello; R. Ritch; J. M. Liebmann
Author Affiliations & Notes
  • I. Forchheimer
    Ophthalmology, New York University Medical Center, New York, New York
  • C. G. De Moraes
    Ophthalmology, New York University Medical Center, New York, New York
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
  • F. A. Folgar
    Ophthalmology, New York University Medical Center, New York, New York
  • C. C. Teng
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • C. Tello
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • R. Ritch
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
    Ophthalmology, New York Medical College, Valhalla, New York
  • J. M. Liebmann
    Ophthalmology, New York University Medical Center, New York, New York
    Ophthalmology, New York Eye and Ear Infirmary, New York, New York
  • Footnotes
    Commercial Relationships  I. Forchheimer, None; C.G. De Moraes, None; F.A. Folgar, None; C.C. Teng, None; C. Tello, Diopsys, Inc., F; Alcon Laboratories, Inc., R; Allergan, Inc., R; R. Ritch, Heidelberg Engineering, GmBH., F; Alcon Laboratories, Inc., C; Allergan, Inc., C; Danube Pharmaceuticals, Inc., C; Pfizer Ophthalmics, Inc., C; Topcon, Inc., F; Carl Zeiss Meditec, Inc., F; Diopsys, Inc., F; J.M. Liebmann, Carl Zeiss Meditec, Inc, F; Diopsys, Inc., F; Heidelberg Engineering, GmbH., F; Optovue, Inc., F; Topcon Medical Systems, Inc., F; Alcon Laboratories, Inc., C; Allergan, Inc., C; Diopsys, Inc., C; Optovue, Inc., C; Pfizer Inc., C; Topcon Medical Systems, Inc., C.
  • Footnotes
    Support  Supported in part by the Joseph Alexander Foundation Fund of the New York Glaucoma Research Institute, New York, NY and Glaucoma Research and Education fund of Lenox Hill Hospital, New York, NY (CGDM)
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 4022. doi:
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      I. Forchheimer, C. G. De Moraes, F. A. Folgar, C. C. Teng, C. Tello, R. Ritch, J. M. Liebmann; Intraocular Pressure, Baseline Visual Field (VF) Mean Deviation (MD), and Glaucoma Progression. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4022.

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Abstract

Purpose: : To evaluate the relationships between VF baseline MD, IOP, and subsequent VF progression in treated glaucoma patients.

Methods: : The charts of all patients seen in a glaucoma referral practice between 1999 and 2009 were reviewed. One eye of subjects with ≥8 SITA-Standard 24-2 VF and baseline VF damage were included (Group A, MD better than -4.20 dB; Group B, MD between -4.21 and -8.17 dB; Group C, worse than -8.17 dB) Patients with other ocular conditions known to affect the VF or insufficient number of VF to create a slope were excluded. Automated pointwise linear regression determined global and localized rates (dB/yr) of change. Progression was defined when 2 or more adjacent test locations in the same hemifield showed a threshold sensitivity decline at a rate of ≥1.0 dB/yr with p<0.01.

Results: : 587 patients (587 eyes; mean age, 64.9±13.0; mean number of VF tests; 11.1±3.0; mean follow-up time, 6.4±1.7 yrs) were enrolled (Group A, n=196; Group B, 195; Group C, 196). For Groups A, B, and C respectively, progression was noted in 30.1%, 31.8%, and 26% of eyes (p=0.43) and global rates of VF change of progressing eyes were -1.3±1.2, -1.01±0.7, and -0.9±0.5 dB/yr (p=0.09). For Groups A, B, and C respectively, IOPs in the stable vs progressing eyes were 15.5±3.3 vs 17.0±3.1 (P<0.01), 15.4±3.3 vs 15.9±2.5 (P=0.28), and 14.0±2.8 vs 14.8±2.3 mmHg (P=0.07). More glaucoma filtering surgeries were performed in eyes with worse MD (Group A, 46; Group B, 73; Group C, 87; p<0.01). Even though there was a weak but significant trend suggesting that eyes with worse MD progressed more slowly (Pearson’s r=-0.08, p=0.03), this association became non-significant after adjusting for the mean follow-up IOP (p=0.37). For Group A, B, and C eyes, respectively, progression occurred in 17%, 17% and 14% at mean IOP ≤12 mmHg, 24%, 32% and 24% at IOP ≤18 mmHg, and 44%, 32% and 50% at IOP>18 mmHg.

Conclusions: : In treated glaucoma, the rate of VF progression is independent of the severity of the baseline VF MD which could be related to the aggressiveness of treatment. Eyes with lower IOP tend to progress less frequently across the spectrum of VF loss.

Keywords: visual fields • intraocular pressure • clinical (human) or epidemiologic studies: risk factor assessment 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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