首页|Factors Threatening Central Visual Function of Patients with Advanced Glaucoma A Prospective Longitudinal Observational Study
Factors Threatening Central Visual Function of Patients with Advanced Glaucoma A Prospective Longitudinal Observational Study
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NSTL
Elsevier
Purpose: To identify risk factors for further deterioration of central visual function in advanced glaucoma eyes. Design: Prospective, observational 5-year study. Participants: Advanced glaucoma patients with well-controlled intraocular pressure (IOP), mean deviation (MD) of the Humphrey Field Analyzer (HFA) 24-2 program <=-20 dB and best-corrected visual acuity (BCVA) of 20/40. Methods: The HFA 10-2 test and BCVA examination were performed every 6 months, and the HFA 24-2 test was performed every 12 months for 5 years. The Cox proportional hazards model was used to identify risk factors for deterioration of HFA 10-2 and 24-2 results and BCVA. Main Outcome Measures: Deterioration of HFA 10-2 results was defined by the presence of the same >= 3 points with negative total deviation slope <=-1 dB/year at P < 0.01 on >= 3 consecutive tests, deterioration of HFA 24-2 results by an increase >= 2 in the Advanced Glaucoma Intervention Study score on >= 2 consecutive tests, and deterioration of BCVA by an increase of >= 0.2 logarithm of the minimum angle of resolution (logMAR) on >= 2 consecutive tests. Results: A total of 175 eyes of 175 patients (mean age, 64.1 years; mean baseline 10P, 13.2 mmHg; mean BCVA, 0.02 logMAR; mean HFA 24-2 and 10-2 MD, -25.9 and -22.9 dB, respectively) were included. The probabilities of deterioration in HFA 10-2 and 24-2 results and BCVA were 0.269 +/- 0.043 (standard error), 0.173 +/- 0.031, and 0.194 +/- 0.033, respectively, at 5 years. Lower BCVA at baseline (P = 0.012) was associated significantly with further deterioration of HFA 10-2 results. Better HFA 24-2 MD (P < 0.001) and use of systemic antihypertensive agents (P = 0.009) were associated significantly with further deterioration of HFA 24-2 results, and a greater beta-pen papillary atrophy area-to-disc area ratio (P < 0.001), use of systemic antihypertensive agents (P = 0.025), and lower BCVA (P = 0.042) were associated significantly with further deterioration of BCVA, respectively. Conclusions: In advanced glaucoma eyes with well-controlled IOP, BCVA, beta-peripapillary atrophy area-to-disc area ratio, and use of systemic antihypertensive agents were significant prognostic factors for further deterioration of central visual function. (C) 2021 by the American Academy of Ophthalmology
NSTL
Elsevier
