Baseline 24-2 Central Visual Field Damage Is Predictive of Global Progressive Field Loss.
Garg Aakriti, De Moraes C Gustavo, Cioffi George A, Girkin Christopher A, Medeiros Felipe A, Weinreb Robert N, Zangwill Linda M, Liebmann Jeffrey M
AI Summary
Baseline central visual field damage in glaucoma predicts faster overall vision loss, indicating these patients need intensive monitoring and treatment.
Abstract
Purpose
Central visual field (VF) damage in glaucoma patients can significantly hinder daily activities. The present study investigates whether the presence of localized baseline damage to the central 10 degrees of the VF is predictive of faster global mean deviation (MD) progression.
Design
Prospective cohort study.
Methods
Eyes from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES) with established glaucoma and VF loss and a minimum of 5 24-2 VFs were eligible. Baseline central 24-2 damage was defined as any of the 12 central-most points with total deviation (TD) values at P < 0.5% on 2 consecutive examinations. Progression was determined using trend-based and event-based criteria: (1) rates of MD change significantly faster than zero and (2) >-5 dB MD loss over the entire follow-up.
Results
A total of 827 eyes of 584 patients were studied. Mean rate of MD change of the entire sample was -0.15 dB/year (95% CI: -0.19 to -0.12, P < .001). Eyes with baseline central damage progressed faster than those without (difference: β central = -0.07 dB/year, 95% CI: -0.11 to -0.01, P = .011) and were more likely to experience MD loss greater than 5 dB (hazard ratio = 3.0 [95% CI: 2.1-4.1, P < .001]). These differences remained significant after adjusting for confounders.
Conclusion
The presence of central VF damage at baseline is significantly associated with more rapid global progression. Detection of central VF damage aids in stratification of high-risk patients who may need intensive surveillance and aggressive treatment.
MeSH Terms
Shields Classification
Key Concepts5
The presence of localized baseline damage to the central 10 degrees of the visual field (defined as any of the 12 central-most points with total deviation values at P < 0.5% on 2 consecutive examinations) in glaucoma patients is predictive of faster global mean deviation (MD) progression.
Eyes with baseline central visual field damage progressed faster than those without, with a difference of -0.07 dB/year (95% CI: -0.11 to -0.01, P = .011) in the mean rate of MD change, in a prospective cohort study of 827 eyes of 584 patients with established glaucoma and VF loss from the multicenter African Descent and Glaucoma Evaluation Study (ADAGES).
Eyes with baseline central visual field damage were more likely to experience mean deviation (MD) loss greater than 5 dB (hazard ratio = 3.0 [95% CI: 2.1-4.1, P < .001]) compared to eyes without, in a prospective cohort study of 827 eyes of 584 patients with established glaucoma and VF loss.
The association between the presence of central visual field damage at baseline and more rapid global progression remained significant after adjusting for confounders in a prospective cohort study of 827 eyes of 584 patients with established glaucoma and VF loss.
Detection of central visual field damage aids in stratification of high-risk glaucoma patients who may need intensive surveillance and aggressive treatment.
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