The Relationship Between Intraocular Pressure and Rates of Central Versus Peripheral Visual Field Progression.
Shukla Aakriti G, De Moraes C Gustavo, Cioffi George A, Girkin Christopher A, Weinreb Robert N, Zangwill Linda M, Liebmann Jeffrey M
AI Summary
This study found IOP parameters similarly impact central and peripheral visual field progression in glaucoma, suggesting IOP control benefits both regions equally.
Abstract
Precis: In this longitudinal prospective cohort study of open-angle glaucoma patients, intraocular pressure (IOP) parameters (mean, fluctuation, and maximum) had a similar effect on glaucomatous progression in the central and peripheral visual field (VF) regions.
Purpose
To study the effects of IOP on rates of glaucomatous central versus peripheral VF progression.
Methods
The African Descent and Glaucoma Evaluation Study (ADAGES) is a longitudinal prospective cohort study that recruited patients from 3 centers. A sample of those with established glaucoma were included in this study. The mean peripheral sensitivity (MPS) and the mean central sensitivity (MCS) were defined based upon the average total deviation of the peripheral and central (10 degrees) points of the 24-2 VF, respectively. Progression was based upon central and peripheral change from linear mixed-effects models. The relationships between VF progression and IOP mean, maximum, and fluctuation as continuous variables were also investigated. Main outcome measures were MPS and MCS progression rates.
Results
A total of 452 eyes of 344 patients were studied. The mean number of VFs (SD) for each eye was 13.3 (6.4) over 9.1 (3.7) years. The mean baseline MD was -5.1 (3.9) dB and the mean rate of MD change was -0.26 dB/y [95% confidence interval (CI): -0.33 to -0.20, P<0.001]. Mean rates of MPS (-0.27 dB/y, 95% CI: -0.33 to -0.22, P<0.001) and MCS change (-0.26 dB/y, 95% CI: -0.31 to -0.21, P<0.001) were similar (P=0.351). Mean, fluctuation, and maximum IOP were significantly associated with MPS and MCS (all P<0.025).
Conclusions
The effect of IOP parameters on VF progression was statistically similar between central and peripheral VF regions.
MeSH Terms
Shields Classification
Key Concepts4
In a longitudinal prospective cohort study of 452 eyes from 344 open-angle glaucoma patients, intraocular pressure (IOP) parameters (mean, fluctuation, and maximum) had a similar effect on glaucomatous progression in the central and peripheral visual field (VF) regions.
In a longitudinal prospective cohort study of 452 eyes from 344 open-angle glaucoma patients, the mean rate of mean peripheral sensitivity (MPS) change was -0.27 dB/y (95% CI: -0.33 to -0.22, P<0.001).
In a longitudinal prospective cohort study of 452 eyes from 344 open-angle glaucoma patients, the mean rate of mean central sensitivity (MCS) change was -0.26 dB/y (95% CI: -0.31 to -0.21, P<0.001).
In a longitudinal prospective cohort study of 452 eyes from 344 open-angle glaucoma patients, mean, fluctuation, and maximum intraocular pressure (IOP) were significantly associated with both mean peripheral sensitivity (MPS) and mean central sensitivity (MCS) (all P<0.025).
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