Progression of visual field in patients with primary open‐angle glaucoma – ProgF study 1

• Published in: Acta ophthalmologica (Oxford, England) Vol. 93; no. 8; pp. e615 - e620
• Main Authors: Aptel, Florent, Aryal‐Charles, Nishal, Giraud, Jean‐Marie, El Chehab, Hussam, Delbarre, Maxime, Chiquet, Christophe, Romanet, Jean‐Paul, Renard, Jean‐Paul
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2015
• Subjects: Aged; Aged, 80 and over; Antihypertensive Agents - therapeutic use; Disease Progression; event analysis; Female; glaucoma; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - drug therapy; Glaucoma, Open-Angle - physiopathology; Humans; Intraocular Pressure; Male; Middle Aged; ocular hypertension; Ocular Hypertension - diagnosis; Ocular Hypertension - drug therapy; Ocular Hypertension - physiopathology; Ophthalmology; progression; Risk Factors; trend analysis; Vision Disorders - diagnosis; Vision Disorders - drug therapy; Vision Disorders - physiopathology; visual field; Visual Field Tests; Visual Fields; progression; visual field; ocular hypertension; glaucoma; trend analysis; event analysis
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/aos.12788

Purpose To evaluate the visual field rate of progression of patients with treated ocular hypertension (OHT) and primary open‐angle glaucoma (POAG) in clinical practice, using the mean deviation (MD) and the visual field index (VFI). Methods Non‐interventional cohort study. From a large multicentre database representative of the French population, 441 eyes of 228 patients with treated OHT or POAG followed up at least 6 years with Humphrey 24.2 Sita‐Standard visual field examination at least twice a year were identified. From initial data, eyes were classified in five groups: 121 with OHT, 188 with early glaucoma (MD greater than −6 dB), 45 with moderate glaucoma (MD −6 to −12 dB), 41 with advanced glaucoma (MD −12 to −18 dB) and 46 with severe glaucoma (MD less than −18 dB). Rate of progression during the follow‐up period was calculated using the trend analysis of the Guided Progression Analysis software. Results The mean duration of follow‐up was 8.4 ± 2.7 years and the mean number of visual field, 18.4 ± 3.5. In eyes with OHT, rate of progression was −0.09 dB/year (−0.17%VFI/year). In eyes with POAG, rate of progression was −0.32 dB/year (−0.83%VFI/year) in eyes with early glaucoma, −0.52 dB/year (−1.81%VFI/year) in moderate glaucoma, −0.54 dB/year (−2.35%VFI/year) in advanced glaucoma and −0.45 dB/year (−1.97%VFI/year) in severe glaucoma. In eyes with POAG, a significant progression (p < 0.05) was detected in 159 of 320 eyes (49.7%) with trend analysis and 117 of 320 eyes (36.6%, likely progression) or 183 of 320 eyes (57.2%, possible and likely progression) with event analysis. Conclusions Primary open‐angle glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow‐up. The rate of progression varies greatly among subjects.