Prediction of functional loss in glaucoma from progressive optic disc damage.
Prediction of functional loss in glaucoma from progressive optic disc damage.
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DOI：
10.1001/archophthalmol.2009.276
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发表时间：
2009-10
影响因子：
--
通讯作者：
Weinreb, Robert N.
中科院分区：
文献类型：
--
作者：
Medeiros, Felipe A.;Alencar, Luciana M.;Zangwill, Linda M.;Bowd, Christopher;Sample, Pamela A.;Weinreb, Robert N.
评估通过纵向立体照片评估检测到的进行性视神经盘损伤的能力，以预测疑似青光眼患者未来功能丧失的发展。该研究对 407 名疑似青光眼患者的 639 只眼睛进行了平均 8.0 年的随访，每年进行标准自动视野检查视野和视盘立体照片。所有患者在基线时均具有正常且可靠的标准自动视野检查结果。转化为青光眼的定义是随访期间出现连续 3 次视野异常。通过对纵向获得的同步立体照片进行分级来评估是否存在进行性视神经盘损伤。其他预测因素包括年龄、眼压、中央角膜厚度、图案标准差和基线立体照片分级。通过扩展 Cox 模型获得预测视野丧失的风险比，其中视盘进展作为时间依赖性协变量。使用修改后的 R2 指数评估预测准确性。进行性视盘损伤的风险比为 25.8（95% 置信区间，16.0-41.7），是视野缺损最重要的风险因素，R2 为 79%。其他预测因素的 R2 范围为 6% 至 26%。立体照片上出现的进行性视盘损伤是青光眼未来功能丧失的高度预测因素。这些发现表明仔细监测视盘外观的重要性以及视盘纵向评估作为临床试验终点和青光眼诊断测试评估参考的潜在作用。
To evaluate the ability of progressive optic disc damage detected by assessment of longitudinal stereophotographs to predict future development of functional loss in those with suspected glaucoma. The study included 639 eyes of 407 patients with suspected glaucoma followed up for an average of 8.0 years with annual standard automated perimetry visual field and optic disc stereophotographs. All patients had normal and reliable standard automated perimetry results at baseline. Conversion to glaucoma was defined as development of 3 consecutive abnormal visual fields during follow-up. Presence of progressive optic disc damage was evaluated by grading longitudinally acquired simultaneous stereophotographs. Other predictive factors included age, intraocular pressure, central corneal thickness, pattern standard deviation, and baseline stereophotograph grading. Hazard ratios for predicting visual field loss were obtained by extended Cox models, with optic disc progression as a time-dependent covariate. Predictive accuracy was evaluated using a modified R2 index. Progressive optic disc damage had a hazard ratio of 25.8 (95% confidence interval, 16.0-41.7) and was the most important risk factor for development of visual field loss with an R2 of 79%. The R2s for other predictive factors ranged from 6% to 26%. Presence of progressive optic disc damage on stereophotographs was a highly predictive factor for future development of functional loss in glaucoma. These findings suggest the importance of careful monitoring of the optic disc appearance and a potential role for longitudinal assessment of the optic disc as an end point in clinical trials and as a reference for evaluation of diagnostic tests in glaucoma.
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影响因子：
13.7
作者：
Gordon, Mae O.
通讯作者：
Gordon, Mae O.
影响因子：
13.7
作者：
Fayers, Tessa;Strouthidis, Nicholas G.;Garway-Heath, David F.
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影响因子：
13.7
作者：
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Artes, Paul H.
影响因子：
4.2
作者：
Medeiros, FA;Zangwill, LM;Weinreb, RN
通讯作者：
Weinreb, RN
影响因子：
13.7
作者：
Medeiros, Felipe A.;Vizzeri, Gianmarco;Weinreb, Robert N.
通讯作者：
Weinreb, Robert N.