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N. Bellios, F. K. Horn, R. Laemmer, B. Link, J. Kremers, C. Y. Mardin, A. G. Junemann; Visual Field Progression Rates in Glaucoma Eyes With Progressive Optic Disc Change. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4026.
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To determine the incidence of visual field progression and change of progression rates in glaucoma patients with morphologic optic disc change.
Two-hundred-ninety-five eyes of 187 patients from the Erlangen Glaucoma Registy with morphologic progression and a follow up of at least 5 years were included in the analysis. Patients underwent annual standard automated perimetry and standardized optic disc colour photography. Progressive optic disc change was defined as a new apparent neuroretinal rim loss, notches, nerve fibre layer defects or disc hemorrhages. The visual fields of the patients with identified optic disc progression were analysed. Linear regression (trend-) analysis was performed for the mean defect index as well as for every single test point of the 30° visual fields (Octopus G1). Visual field progression was defined as a cluster of at least two points, or three points anywhere in the field with a significant loss of sensitivity (p<0.05) confirmed in two consecutive examinations. Incidence and time of progression as well as rates of MD change before and after optic disc progression were calculated.
Mean follow-up time was 11.35±3.57 years. Optic disc progression occurred after 6.45±3.29 years. Visual field progression as identified with pointwise linear progression criteria occurred in 208 eyes (70.5%) after a mean follow-up of 6.20±2.87 years. The overall mean defect slope was 0.12dB/year. MD slopes before and after morphologic progression were 0.03dB/year and 0.21dB/year respectively. Initial optic disc damage and initial mean defect had a moderate correlation with rate of progression (r=0.294 and r=0,152).
Visual field progression occurred in the majority of the eyes with identified optic disc progression. Progression rates were higher after identified optic disc change. Severity of initial morphologic and functional damage has an only weak correlation with future visual field progression.
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