Baseline visual field defects may predict glaucoma progression
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SAN DIEGO — Visual field defect on baseline 10-2 testing most effectively predicted subsequent progression on 24-2 testing in patients with glaucoma, Michael J. Sullivan-Mee, OD, FAAO, said at an Academy 2022 press conference.
“Not everybody with glaucoma progresses at the same rate,” Sullivan-Mee, of Eye Associates of New Mexico, said during the virtual event. “It’s always been a goal to predict who will progress quickly.
“Studies in the past have tried to identify specific glaucoma risk factors for progression,” he said. “But even when you put all those together, the ability to predict which patients will progress is modest. We need to identify additional risk factors.”
Sullivan-Mee and colleagues evaluated 394 eyes of 202 individuals (119 with primary open-angle glaucoma and 83 glaucoma suspects) who were participating in a prospective longitudinal study in a VA medical center outpatient eye clinic.
All participants had two reliable baseline 10-2 visual field tests and no less than five good quality 24-2 tests over at least 3 years. The primary outcome was rate of change with the 24-2 test (amount of deterioration over time), and secondary event outcomes were patients with a definite worsening of visual field. Predictor variables were evaluated for relation to rate of progression.
According to the study, Cox Proportional Regression analyses that evaluated progression events indicated a 22 times greater risk for developing future loss in eyes with vs. without baseline 10-2 visual field loss.
“We found three independent risk factors for progression, including older age and worse visual field loss at baseline, but the new factor is the presence of baseline 10-2 visual field loss,” he said. “It was the strongest predictor. These findings suggest baseline 10-2 visual field testing has a unique value for predicting future glaucoma progression.”
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Sullivan-Mee M, et al. Baseline 10-2 visual field loss as a predictor for future glaucoma progression. Presented at: Academy; Oct. 26-29, 2022; San Diego.
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