Fast Progressors in Glaucoma: Prevalence Based on Global and Central Visual Field Loss in a Clinical Population

Abstract

Purpose : To determine the prevalence of fast progressors based on both global and central visual field loss in a clinical cohort of glaucoma patients.

Methods : A retrospective review of patients under routine care at an ophthalmology clinic in Melbourne was undertaken to identify those with glaucoma without any other confounding conditions that had undergone ≥5 visual field tests over a 1–5 year period. The rates of change in the global mean deviation from the entire 24-2 visual field test (MD₂₄) and mean total deviation of the 12 locations in the central 10° (MTD₁₀) were calculated using ordinary least squares regression.

Results : Amongst the 295 eyes from 190 patients with glaucoma included in this study, 6.1% and 9.2% of eyes had a rate of change of <-1.0 dB/year on for MD₂₄ and MTD₁₀, and 18.7% and 23.0% had a rate of change <-0.5 dB/year respectively. Furthermore, 17.7% and 21.7% of eyes exhibited a rate of change in the top 5% of the estimated normal distribution (based on the positive slopes) for MD₂₄ and MTD₁₀ respectively.

Conclusions : Although most patients with glaucoma under routine care in this cohort showed relatively slow rates of global visual field loss, nearly one-quarter of eyes exhibited central visual field loss <-0.5 dB/year, a rate that is relatively fast considering the significance of central vision on functional disability. These findings underscore the need for new management strategies and/or interventions to better prevent functional impairment in patients with glaucoma.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.