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C.C. Christiansson, B. Bengtsson, A. Heijl; Long-term Visual Outcome for Patients with High-risk Ocular Hypertension . Invest. Ophthalmol. Vis. Sci. 2003;44(13):96.
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Purpose: To study visual outcome focusing on blindness caused by glaucoma in patients with high-risk ocular hypertension. Methods: Study protocols and post study data from 90 patients included in a high risk ocular hypertension study (Heijl & Bengtsson; Graefe’s Arch 2000) were retrieved. Number of eyes and time to blindness from inclusion were registered and analysed by the Kaplan Meier method. Blindness was defined as VA ≤ 0.05 or a visual field restricted to ≤ 20° from fixation. High risk ocular hypertension was defined as IOP ≥ 22 mm Hg and at least one additional risk factor, i.e. suspicious disc, diabetes, exfoliation or pigment dispersion syndrome, an IOP ≥ 27 mm Hg or a family history of glaucoma. Results: Mean follow-up time was 14.2 years, ranging from 0.8 to 20.1 years. 38 patients died during the study, leaving 19 men and 33 women alive at the end of the study. A total of seven eyes became blind due to glaucoma including both eyes in one patient. A conventional Kaplan Meier curve using glaucoma blindness as survival function showed 5.6 % blind eyes after 20 years. A modified Kaplan Meier curve not considering deceased patients to be censored, as they cannot become blind after death, resulted in 4.2 % blind eyes after 20 years. Another seven eyes became blind due to causes other than glaucoma. Conclusions: One patient became blind due to glaucoma. There was thus a small but definite risk for glaucoma blindness in these patients with high-risk ocular hypertension. The ratio of blind eyes was overestimated when considering deceased patients at risk for blindness.
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