Medication adherence, visual field loss significantly associated
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In patients with glaucoma who reported never missing a single dose of medication over 8 years, the estimated loss of visual field was significantly less when compared with patients who reported missing doses, according to a study.
The Collaborative Initial Glaucoma Treatment Study compared initial treatment of topical medications and trabeculectomy in 607 participants with newly diagnosed glaucoma. Researchers evaluated the relationship between medication adherence and visual field progression in 307 participants who were randomly assigned to the medication arm of the study.
Participants were followed up at 6-month intervals for up to 10 years. The subjects self-reported medication adherence, and visual fields were measured. Adherence data were available for 306 patients.
Over all available follow-up, 142 participants reported never missing a dose of medication, 112 reported a missed dose at up to one-third of visits, 31 reported a missed dose between one-third and two-thirds of visits, and 21 reported a missed dose at more than two-thirds of visits.
The estimated loss of visual field over 8 years for patients who self-reported never missing a dose of medication was 0.62 dB. In comparison, for participants who self-reported missing medication doses at one-third of visits had an estimated visual field loss of 1.42 dB, a statistically significant difference (P < .0001). Participants who self-reported missing medication doses at one-third to two-thirds of visits had an estimated visual field loss of 1.82 dB (P < .0001). Finally, participants who self-reported missed medication doses at two-thirds of visits or more had an estimated visual field loss of 2.23 dB (P < .0001).
Participants who missed no medication doses had a similar estimated visual field loss as age-related visual field loss of patients with stable glaucoma, a typical loss ranging between 0.05 dB and 0.1 dB per year.
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