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Rate of glaucoma progression may depend on severity of vision loss at presentation
Ophthalmology. 2011;118(2):249-253.
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In the early stages of glaucoma, the rate of progression may increase as the severity of visual field loss increases, while later stages may be associated with a decrease in progression for those with severe vision loss, a study found.
The retrospective, clinic-based study included 512 eyes of 310 patients with either primary open-angle glaucoma or primary angle-closure glaucoma. Humphrey VF analyzer examinations using Guided Progression Analysis software (Carl Zeiss Meditec) were used to determine the rate of annual progression over a mean period of 6.8 years.
All subjects had more than five visual field examinations. Visual field loss was classified as either mild (mean deviation greater than –6 dB), moderate (mean deviation between –6 dB and –12 dB) or severe (mean deviation less than –12 dB).
A significant positive relationship between mean deviation and rate of progression was shown for mild eyes, and a significant negative relationship was shown for severe eyes (both P = .001)
No association was shown for those with moderate vision loss, the authors noted.
The rate of progression increased by 0.02% per year for every dB of worsening mean deviation and for every year of increasing age (P = .02).
Rate of progression was not significantly associated with gender, type of primary glaucoma or length of follow-up.
The gradual decrease in rate of progression for severe eyes may be explained by the lessening of available visual field to lose, the study authors wrote.
"There is clearly more work needed to develop methods for detecting glaucoma progression in this group of eyes with severe glaucomatous damage," they said.