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Elevated IOP, age associated with glaucomatous visual field loss
Ophthalmology. 2010;117(9):1705-1712.
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Development of glaucomatous visual field loss was strongly associated with elevated IOP, age, male gender, high myopia and family history of glaucoma, a large study found.
The authors reported the 10-year incidence of glaucomatous visual field loss and associated risk factors. Data were from the Rotterdam Study, a prospective population-based cohort analysis designed to gauge chronic disease incidence and associated risk factors in white patients age 55 years and older.
"Although many studies have reported on the prevalence of [open-angle glaucoma], only a limited number of studies have addressed its incidence," the study authors said. "Furthermore, risk-factor analyses based on current knowledge suffer from wide confidence intervals, and therefore, more well-described incidence data from population-based studies are indispensable. Recent studies that aimed to address the feasibility of [open-angle glaucoma] screening were not able to settle this issue definitively because sufficiently reliable data on the incidence of [glaucomatous visual field loss] and [open-angle glaucoma] were lacking."
The glaucoma arm of the Rotterdam Study included 6,723 patients who underwent visual field screening and optic disc assessment; 93 patients with glaucomatous visual field loss were excluded, leaving 6,630 patients at risk of developing glaucomatous visual field loss.
Overall, 2,571 patients (39%) completed two follow-up examinations over a mean interval of 9.8 years. Results showed that 108 patients developed glaucomatous visual field loss. The overall incidence rate was 2.9 per 1,000 person-years with a 10-year risk of glaucomatous visual field loss of 2.8%. Ten-year risk of incident glaucomatous visual field loss was 1.9% in patients age 55 to 59 years and 6.4% in patients age 80 and older (P < .001).
Glaucomatous visual field loss risk increased 11% for each rise in IOP of 1 mm Hg. Family history was significantly associated with development of visual field loss when IOP was excluded from analysis (P = .012), the authors said.