Abstract
Purpose :
Annual visual field (VF) testing is recommended for adults with glaucoma, though more frequent testing has been shown to better identify glaucomatous progression. No formal recommendations exist for VF testing frequency in children with glaucoma. This study evaluated VF testing frequency in children with glaucoma and characteristics associated with VF frequency.
Methods :
Retrospective chart review of children with glaucoma aged 6-18 years seen between Aug 2018-May 2023. Patients were divided into those who had ≥ 1 VF (group 1) and 0 VFs (group 2). Clinical characteristics extracted included self-reported race, primary language, glaucoma diagnosis, insurance type, and best corrected visual acuity (BCVA). For Group 1, VF data was collected including visual field index, mean deviation, and reliability metrics, and VF testing frequency was determined as the number of VF/year during the study period. Office visit frequency was determined as the number of visits/year during the study period. Among group 1, univariable and multivariable linear regression models were used to assess for risk factors associated with VF frequency. Differences between groups were assessed using a two-sample t-test and chi-squared test.
Results :
82 patients met inclusion criteria (61 patients in group 1, 21 patients in group 2). Children in group 2 were younger (9.8 vs. 11.8 years, p=0.003), had worse BCVA (better eye, p<0.001 and worse eye, p=0.006), and were more likely to have glaucoma associated with non-acquired systemic disease (GASD) and glaucoma following cataract surgery (GFCS, p=0.02, Table 1). Of the 303 VF tests performed in group 1, mean number of VF/year was 1.3±0.8 (39.3% <1 VF/year, 45.9% ≥1 to <2 VF/year, and 14.8% ≥2 VF/year), and 44.9% of VF were reliable. In univariable analysis, Black and multiracial patients had lower VF testing frequency (p=0.01); better BCVA at first VF and greater office visit frequency were associated with higher VF frequency (p=0.045 and p<0.001, respectively; Table 2). No more than one factor was independently associated with VF testing frequency in multivariable analysis.
Conclusions :
Compared to those who did not have VF testing, children with VF testing had better vision and were less likely to have GASD or GFCS. Most children had between 1-2 VF/year. Racial and patient characteristic differences in VF frequency suggest that ophthalmologists should consider barriers to care in glaucoma monitoring.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.