Progression of visual field in patients with primary open-angle glaucoma - ProgF study 1.

Abstract

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). 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 6years 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 -6dB), 45 with moderate glaucoma (MD -6 to -12dB), 41 with advanced glaucoma (MD -12 to -18dB) and 46 with severe glaucoma (MD less than -18dB). Rate of progression during the follow-up period was calculated using the trend analysis of the Guided Progression Analysis software. The mean duration of follow-up was 8.4±2.7years and the mean number of visual field, 18.4±3.5. In eyes with OHT, rate of progression was -0.09dB/year (-0.17%VFI/year). In eyes with POAG, rate of progression was -0.32dB/year (-0.83%VFI/year) in eyes with early glaucoma, -0.52dB/year (-1.81%VFI/year) in moderate glaucoma, -0.54dB/year (-2.35%VFI/year) in advanced glaucoma and -0.45dB/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. 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.