Investigative Ophthalmology & Visual Science Cover Image for Volume 61, Issue 7
June 2020
Volume 61, Issue 7
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ARVO Annual Meeting Abstract  |   June 2020
Visual Field Improvement in Untreated Normal-tension Glaucoma Patients with Stable Intraocular Pressure
Author Affiliations & Notes
  • Yuanbo Liang
    The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
    School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
  • Kun Zhou
    The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
  • Xiao Shang
    The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
  • XIaojie Wang
    The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
  • Footnotes
    Commercial Relationships   Yuanbo Liang, None; Kun Zhou, None; Xiao Shang, None; XIaojie Wang, None
  • Footnotes
    Support  Zhejiang Province Health Innovation Talents project No. 2016025
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3884. doi:
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    • Get Citation

      Yuanbo Liang, Kun Zhou, Xiao Shang, XIaojie Wang; Visual Field Improvement in Untreated Normal-tension Glaucoma Patients with Stable Intraocular Pressure. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3884.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the extent and frequency of visual field (VF) improvement in untreated patients with normal-tension glaucoma (NTG) from Wenzhou Glaucoma Progression Study.

Methods : This was a longitudinal, observational study. 156 eyes of 101 untreated NTG patients who had previously undergone ≥5 reliable visual fields (VFs) were included. The mean deviation (MD) slope was calculated using Glaucoma Progression Analysis (GPA) from selected “Baseline” to “Last Improved Visit”. VF improvement was defined as an increase of ≥+0.5 dB/year in the MD slope. IOP measurements, VF global indices, ocular coherence tomography (OCT) parameters and fundus photographs were analyzed to determine whether they showed reversal. Main outcome measures: The change in MD (ΔMD) and number of reliable VFs (No. of VFs) over follow-ups were used to describe VF improvement.

Results : 79 eyes (51%) were defined as VF improved eyes in a mean period of 20.9±8.89 months. Among them, 63 eyes (40%) showed MD improvement within 6 dB, whereas 16 eyes (10%) showed improvement greater than 6 dB. 37 eyes (24%), 34 eyes (22%) and 8 eyes (5%) showed continuous improvement during 5-6 visits, 7-11 visits and 12-14 visits, respectively. Between “Baseline” and “Last Improved Visit”, the test duration and VF global indices both showed improvement, all P values<0.001. And there was no obvious disease reversal suggested by intraocular pressure (IOP) and OCT parameters.

Conclusions : There was significant VF improvement observed in untreated NTG eyes with stable IOP and no significant optic disc reversal, suggesting a long existing learning effect.

This is a 2020 ARVO Annual Meeting abstract.

 

Glaucoma Progression Analysis(GPA) results and Optic Nerve Head(ONH) photography of a visual field (VF) improved eye. The GPA results showed a significant VF improvement in a 68-year old male normal-tension glaucoma patient. A mean deviation (MD) slope of +1.0±0.5 dB/year was noted during 14 No. of VFs. The MD improved from -5.85 dB in “Baseline” to 0.70dB in “Last Improved Visit” (ΔMD=6.55 dB). The corresponding ONH photography at the “Baseline” and “Last Improved Visit” showed no evidence of ONH reversal in these two photographs.

Glaucoma Progression Analysis(GPA) results and Optic Nerve Head(ONH) photography of a visual field (VF) improved eye. The GPA results showed a significant VF improvement in a 68-year old male normal-tension glaucoma patient. A mean deviation (MD) slope of +1.0±0.5 dB/year was noted during 14 No. of VFs. The MD improved from -5.85 dB in “Baseline” to 0.70dB in “Last Improved Visit” (ΔMD=6.55 dB). The corresponding ONH photography at the “Baseline” and “Last Improved Visit” showed no evidence of ONH reversal in these two photographs.

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