Abstract
Purpose :
To identify factors predictive of visual field progression in eyes that developed POAG in the Ocular Hypertension Treatment Study
Methods :
282 participants developed POAG in OHTS 1 and 2 by study criteria: 1. Reproducible optic disc deterioration and/or visual field (VF) abnormality as determined by Reading Centers; and 2. Attribution of change to POAG by a masked Endpoint Committee. Inclusion in slope analyses required at least 5 VF’s over 3 years after POAG diagnosis. Among participants who did not develop POAG in either eye, inclusion required at least 6 VF tests over 6 years. Simple linear regression was used to calculate slope of mean deviation (MD dB/year) for each eye. Multivariable linear mixed effects models with 20 multiple imputations for missing data (IVERWARE) were used to identify factors predictive of visual field progression. Factors with p-values < 0.05 are reported. Accuracy of prediction was calculated by R 2 (C) and by comparing agreement between predicted vs. observed slope by tertile of predicted slope.
Results :
Mean number of post-POAG VF tests per eye was 12 tests over mean follow-up of 8.9 years. Mean slope was -0.07+/- 0.11 dB/yr in participants who did not develop POAG in either eye (1083 eyes) ; -0.19 +/- 0.37 dB/year in eyes that developed optic disc POAG only (112 eyes); and -0.54 +/- 0.75 dB/yr. in eyes that developed VF POAG with/without optic disc POAG (168 eyes). Factors associated with post-POAG MD slope were age, horizontal cup disc ratio and pattern standard deviation at the time of POAG diagnosis as well as the mean and standard deviation of IOP after POAG diagnosis. R2 (C) for this model was 0.70. Agreement between predicted and observed slopes from the lowest to highest tertile was within 0.11, -0.10 to 0.01 respectively.
Conclusions :
The 5 factor prediction model of VF progression had moderate to high explanatory power. Agreement between predicted and observed MD slopes was high over the range of VF progression.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.