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Rachel Frantz, Alon Harris, Alice Chandra Verticchio Vercellin, Nicholas Moore, Tyler Joseph Knight, Betul Kaskan, George Eckert, Darrell WuDunn, Brent A Siesky; Functional and structural glaucoma progression after five years in patients with lowered intraocular pressure. Invest. Ophthalmol. Vis. Sci. 2016;57(12):352.
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© ARVO (1962-2015); The Authors (2016-present)
To examine the longitudinal changes in intraocular pressure (IOP) and functional and structural parameters in open-angle glaucoma (OAG) patients over a five-year period
111 patients (mean age 65 ± 10.9 years; 68 female, 43 male) with OAG were assessed for changes in IOP, visual fields were evaluated by Humphrey 24-2, and optic nerve head morphology was assessed by Heidelberg retinal tomography 3 every six months for five years. Mixed-model ANCOVA was used to test for statistically significant changes from baseline to five-year follow-up.
IOP decreased from baseline 16.7 to 15.3 at five years, mean change of -1.4 (95% CI: -2.4, -0.5). Mean deviation decreased from -3.4 to -4.9, change of -1.5 (-2.4, -0.6). Pattern standard deviation increased from 4.0 to 4.9, change of 0.9 (0.4, 1.3). Advanced Glaucoma Intervention Study score increased from 1.4 to 2.1, change of 0.6 (0.3, 0.8) (p<0.05).Structural changes were also observed from baseline to five years, respectively: cup volume increased from 0.296 to 0.319, change of 0.023 (0.003, 0.042); cup/disc area ratio increased from 0.410 to 0.429, change of 0.019 (0.000, 0.038); mean cup depth increased from 0.300 to 0.309, change of 0.009 (0.001, 0.018); cup shape increased from -0.128 to -0.115, change of 0.014 (0.004, 0.024); height variation contour increased from 0.330 to 0.353, change of 0.022 (0.004, 0.040) (p<0.05).
In OAG patients monitored from baseline to five years, visual function worsened and structural damage progressed, despite an overall decrease in IOP. These findings indicate that other factors, besides IOP, influence both structural and functional disease progression.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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