Risk Factors for Visual Field Progression in Treated Glaucoma
Risk Factors for Visual Field Progression in Treated Glaucoma
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DOI：
10.1001/archophthalmol.2011.72
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发表时间：
2011-05-01
影响因子：
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通讯作者：
Ritch, Robert
中科院分区：
文献类型：
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作者：
De Moraes, Carlos Gustavo V.;Juthani, Viral J.;Ritch, Robert
目的：目的：确定青光眼治疗后视野进展相关的眼内压（IOP）依赖性和眼内压无关性变量。设计：青光眼进展研究的回顾性队列。方法：连续性青光眼治疗患者，每只眼有8次或以上VF检查，使用瑞典交互阈值算法（24 - 2 SITA-标准，Humphrey Field Analyzer II; Carl Zeiss Meditec，Inc，都柏林，加州）。使用自动逐点线性回归评价视野进展。评估数据包括年龄、性别、种族、中央角膜厚度、基线VF平均偏差、平均随访IOP、峰值IOP、IOP波动、检测到的椎间盘出血和存在β区乳头旁atrophilia. Results：我们选择了587例患者的587只眼（平均[SD]年龄，64.9 [13.0]岁）。VF的平均（SD）次数为11.1（3.0），平均（SD）时间跨度为6.4（1.7）年。在单变量模型中，（比值比[OR]，1.19/10; P =.01），基线诊断为剥脱综合征（OR，1.79; P =.01），中央角膜厚度减少（OR，1.38/40 μ m; P <.01），检测到椎间盘出血（OR，2.31; P <0.01），存在β区乳头旁萎缩（OR，2.17; P <0.01），以及所有IOP参数（平均随访、峰值和波动; P <0.01）与VF进展风险增加相关。在多变量模型中，峰值IOP（OR，1.13，P <.01），中央角膜厚度较薄（OR，1.45/40 μ m; P <.01），检测到椎间盘出血（OR，2.59; P <.01），以及存在β区乳头旁萎缩结论：眼压依赖性和眼压非依赖性危险因素影响青光眼治疗后的疾病进展。峰值IOP是比IOP平均值或波动更好的进展预测因子。
Objective: To determine intraocular pressure (IOP)-dependent and IOP-independent variables associated with visual field (VF) progression in treated glaucoma.Design: Retrospective cohort of the Glaucoma Progression Study.Methods: Consecutive, treated glaucoma patients with repeatable VF loss who had 8 or more VF examinations of either eye, using the Swedish Interactive Threshold Algorithm (24-2 SITA-Standard, Humphrey Field Analyzer II; Carl Zeiss Meditec, Inc, Dublin, California), during the period between January 1999 and September 2009 were included. Visual field progression was evaluated using automated pointwise linear regression. Evaluated data included age, sex, race, central corneal thickness, baseline VF mean deviation, mean follow-up IOP, peak IOP, IOP fluctuation, a detected disc hemorrhage, and presence of beta-zone parapapillary atrophy.Results: We selected 587 eyes of 587 patients (mean [SD] age, 64.9 [13.0] years). The mean (SD) number of VFs was 11.1 (3.0), spanning a mean (SD) of 6.4 (1.7) years. In the univariable model, older age (odds ratio [OR], 1.19 per decade; P = .01), baseline diagnosis of exfoliation syndrome (OR, 1.79; P = .01), decreased central corneal thickness (OR, 1.38 per 40 mu m thinner; P < .01), a detected disc hemorrhage (OR, 2.31; P < .01), presence of beta-zone parapapillary atrophy (OR, 2.17; P < .01), and all IOP parameters (mean follow-up, peak, and fluctuation; P < .01) were associated with increased risk of VF progression. In the multivariable model, peak IOP (OR, 1.13; P < .01), thinner central corneal thickness (OR, 1.45 per 40 mu m thinner; P < .01), a detected disc hemorrhage (OR, 2.59; P < .01), and presence of beta-zone parapapillary atrophy (OR, 2.38; P < .01) were associated with VF progression.Conclusions: IOP-dependent and IOP-independent risk factors affect disease progression in treated glaucoma. Peak IOP is a better predictor of progression than is IOP mean or fluctuation.