Progression of Visual Field Damage within Clusters Depends on Preexisting Damage.

Abstract

To investigate, in a routine clinical setting, how global progression or progression within visual field clusters depends on preexisting damage. Glaucoma patients with a visual field damage of at least 3 dB at baseline and a series of at least 5 good quality examinations were scrutinized retrospectively. The change in visual field damage within 10 visual field clusters was assessed in a mixed linear effects model with age, baseline global mean deviation (MD), baseline cluster MD, and observation time as covariates. In addition, progression was tested for a global MD rate with age, baseline global MD, and observation time as covariates. A total of 50 patients with a mean (± SD) age of 78(± 13) years and a baseline global mean defect (MD) of 7.6 dB (± 4.4) fulfilling the selection criteria were identified between 2001 and 2019 out of 5019 patients in a visual field database of a tertiary ophthalmology center. Baseline visual field damage (global MD) correlated positively (p < 0.001) with the progression rate within clusters, but not with the global MD rate (p = 0.075). Higher age was a significant predictor for more rapid progression in both models (p < 0.001). In this retrospective study of patients in a routine clinical setting, who were not enrolled in studies, and simply receiving routine clinical care, analyzing progression within visual field clusters was more sensitive than assessing the global MD rate.