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Shonraj Ballae Ganeshrao, Sirisha Senthil, Nikhil Choudhari, Shravya Sri Durgam, Chandra Sekhar Garudadri; Comparison of Visual Field Progression Rates Among the High Tension Glaucoma, Primary Angle Closure Glaucoma, and Normal Tension Glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(4):889-900. doi: https://doi.org/10.1167/iovs.18-25421.
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To compare the visual field (VF) progression among high tension glaucoma (HTG), primary angle closure glaucoma (PACG), and normal tension glaucoma (NTG) subjects in routine clinical care.
All patients had ≥5 VF tests using HFA, 24-2, SITA-standard strategy. We compared the progression between glaucoma subtypes after matching the VFs for baseline severity (mean deviation [MD]) and the age at presentation. Global VF progression was evaluated by linear regression analysis (LRA) of MD. For local VF progression, scotoma expansion (SE) defined as appearance of new scotoma and scotoma deepening (SD) defined by pointwise LRA were calculated. SE and SD were analyzed in three VF zones: superior arcuate (SA), inferior arcuate (IA), and central (C).
A total of 310 HTG, 304 PACG, and 165 NTG eyes were included. When VFs were matched by baseline MD, a greater number (n = 20/76) of eyes with HTG showed significant progression compared to PACG (n = 9/76; P = 0.04). The number of progressing eyes were not significantly different between HTG and NTG (n = 11/76; P = 0.10) and between NTG and PACG (P = 0.65). When the baseline VFs were matched by age, the number of eyes showing significant progression were similar in all the subtypes. SA zone in HTG and NTG showed greater SE and SD compared to other zones (P < 0.05), whereas IA zone in PACG showed greater SE and SD compared to other zones (P < 0.05).
In our cohort of treated primary glaucoma with matched baseline severity, a greater proportion of HTG eyes progressed faster compared to PACG. SA zone in HTG and NTG and IA zone in PACG showed greater VF progression.
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