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A. G. Junemann, N. Bellios, R. Laemmer, B. Link, C. Y. Mardin, J. Kremers, F. E. Kruse, F. K. Horn; Long-Term Follow-Up of Preperimetric Open-Angle Glaucoma: Improvement of the Visual Field in Morphological Stable Patients Only. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5517.
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To evaluate visual field changes in patients with preperimetric open-angle glaucoma (preOAG) with and without morphological progression.
159 patients with preperimetric open-angle glaucoma of the Erlangen Glaucoma Registry with a follow-up of at least 6 years (mean follow-up 8.45±2.3 years) were included in this study (55.6±10.6 years, 71 female, 88 male). Examinations were performed yearly. The visual field was analysed in a morphological stable (s-group) and progressive group (p-group). The morphological progression was defined using color stereo photographs of the optic disk. Progression criteria included reduction of neuroretinal rim, occurrence of notches, and hemorrhages. The mean defect (MD, Octopus 500, G1 program) as a global parameter was used for visual field analysis. In addition, the baseline data of age, maximal intraocular pressure, neuroretinal rim area, central corneal thickness, value of lens opacity meter for cataract formation were analysed. Non-parametric testing (Mann-Whitney U, Friedman) was performed.
Morphological progression was found in 62 patients (39%). The MD showed no significant difference between both groups at every examination time point (Mann-Whitney, p>0.5), including baseline. The s-group showed a significant improvement of MD between baseline (0.765±1.1dB) and endpoint (-0.45±1.5dB, Friedman, p<0.05). The p-group showed no significant difference (0.755±0.94dB, 0.975±1.5dB, p>0.1). There was no significant difference for age, maximal IOP, neuroretinal rim area, central corneal thickness, and lens opacity meter between both groups at baseline (p>0.5).
This study suggest that a stable MD might not to be sufficient to define a stable visual field in longitudinal studies. The lack of long-time learning effect in patients with morphological progression may indicate a deterioration of the visual field.
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