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PP Chen; Blindness in Patients with Chronic Forms of Open Angle Glaucoma . Invest. Ophthalmol. Vis. Sci. 2002;43(13):273.
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Purpose: To investigate blindness in patients with chronic forms of open angle glaucoma (OAG), and risk factors for blindness. Methods: Review of patients seen between April and November 2000 at the University of Washington Medical Center Eye Clinic, diagnosed in 1975 or later, and treated for at least 2 years for chronic OAG. Visual acuity and visual fields were evaluated, and Kaplan-Meier survival analysis was used to estimate the risk of blindness. Blindness was defined as visual acuity of 20/200 or worse, and/or continuous constriction of the visual field to 20 degrees or less in all 4 quadrants with a size III4e Goldmann stimulus or the equivalent on automated perimetry, allowing a higher threshold on one point in one quadrant on automated perimetry. Variables considered to be risk factors for blindess were evaluated using chi square, t-test, and Cox proportional hazards regression analysis. Results: 183 patients fulfilled inclusion criteria. The mean duration of disease was 10.0 +/- 5.1 years. Twelve patients were blind from OAG in at least one eye at diagnosis. Eighteen other patients became blind from OAG in at least one eye, and 3 patients became bilaterally blind. The Kaplan-Meier estimate for blindness at 15 years in one eye was 14.0%, and in both eyes was 4.3%. Worse initial visual field loss (<.0001) and non-compliance (P = .017) were associated with the development of blindness. Non-white race was associated with blindness (P = .011) when all blindness, including that found at diagnosis, was considered in the analysis. Conclusion: Bilateral blindness from chronic OAG was uncommon in this population of treated patients diagnosed in 1975 or later. Of patients with a blind eye, 40% were blind at diagnosis. Worse initial visual field loss and noncompliance were associated with the development of blindness.
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