Rates of Visual Field Progression Before and After the Onset of Atrial Fibrillation.
Nishida Takashi, Moghimi Sasan, Jin Wang, Zangwill Linda M, Weinreb Robert N
AI Summary
Atrial fibrillation and related microvascular damage were linked to slightly faster visual field loss in glaucoma patients, highlighting the need to manage cardiovascular risk factors.
Abstract
Précis: This case-control study investigated the effect of atrial fibrillation (AF) on the progression of glaucoma. The presence of AF and related microvascular damage was associated with a slightly faster visual field loss in glaucoma patients.
Purpose
To investigate the effect of atrial fibrillation (AF) on glaucoma progression.
Methods
In this longitudinal case-control study, a total of 144 eyes from 105 patients with primary open angle glaucoma were included. Forty-eight eyes of case developed AF during the follow-up followed for 15.6 years. Ninety-six eyes of control that did not have AF at baseline or during follow-up matched for age, baseline glaucoma severity, and follow-up period were followed for an average of 14.7 years. Mixed-effects linear models were used to calculate the difference in the VF MD slopes before and after the AF. CHADS 2 and CHA 2 DS 2 -VASc scores were used to evaluate the risk of thrombosis event, and related microvascular damage was assessed based on these scores.
Results
The rate of VF MD change was -0.20 (-0.42 to 0.02) dB/y before AF and -0.28 (-0.47 to -0.09) dB/y after AF for the patients with AF, and -0.21 (-0.25 to -0.17) dB/y for the control. In the multivariable models, the VF slope difference before and after the onset of AF [-0.10 (-0.14 to -0.05) dB/y, P <0.001], higher CHADS 2 score [-0.07 (-0.13 to 0.00) dB/y per 1 unit, P =0.040], and higher CHA 2 DS 2 -VASc score [-0.05 (-0.10 to 0.00) dB/y per 1 unit, P =0.039] were associated with faster VF MD loss.
Conclusions
The presence of atrial fibrillation and related microvascular damage might accelerate visual field loss. This underscores the need for a comprehensive medical history and management of cardiovascular risk factors to mitigate increased VF loss in glaucoma.
MeSH Terms
Shields Classification
Key Concepts5
In a longitudinal case-control study of 144 eyes from 105 patients with primary open angle glaucoma, the rate of visual field mean deviation (VF MD) change was -0.20 dB/y (-0.42 to 0.02 dB/y) before atrial fibrillation (AF) and -0.28 dB/y (-0.47 to -0.09 dB/y) after AF for the patients with AF, compared to -0.21 dB/y (-0.25 to -0.17 dB/y) for the control group.
In multivariable models from a longitudinal case-control study of 144 eyes from 105 patients with primary open angle glaucoma, the visual field (VF) slope difference before and after the onset of atrial fibrillation (AF) was -0.10 dB/y (-0.14 to -0.05 dB/y, P <0.001), indicating a faster VF MD loss.
In multivariable models from a longitudinal case-control study of 144 eyes from 105 patients with primary open angle glaucoma, a higher CHADS2 score was associated with a faster visual field mean deviation (VF MD) loss [-0.07 dB/y (-0.13 to 0.00 dB/y per 1 unit, P =0.040)].
In multivariable models from a longitudinal case-control study of 144 eyes from 105 patients with primary open angle glaucoma, a higher CHA2DS2-VASc score was associated with a faster visual field mean deviation (VF MD) loss [-0.05 dB/y (-0.10 to 0.00 dB/y per 1 unit, P =0.039)].
A longitudinal case-control study included 48 eyes of patients who developed atrial fibrillation (AF) during follow-up (average 15.6 years) and 96 control eyes without AF at baseline or during follow-up (average 14.7 years), matched for age, baseline glaucoma severity, and follow-up period.
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