To investigate the risk factors associated with visual field (VF) progression in the Advanced Glaucoma Intervention Study (AGIS) with pointwise linear regression (PLR) analysis of serial VFs. ⋯ Both increasing age and greater IOP fluctuation increase the odds of VF progression by 30% (for each 5-year increment in age and 1-mmHg increase in IOP fluctuation). The higher risk conferred by IOP fluctuation was consistently observed in eyes with and without a history of cataract extraction.
Kouros Nouri-Mahdavi, Douglas Hoffman, Anne L Coleman, Gang Liu, Gang Li, Douglas Gaasterland, Joseph Caprioli, and Advanced Glaucoma Intervention Study.
Glaucoma Division, Jules Stein Eye Institute, University of California Los Angeles 90095, USA.
Ophthalmology. 2004 Sep 1; 111 (9): 1627-35.
PurposeTo investigate the risk factors associated with visual field (VF) progression in the Advanced Glaucoma Intervention Study (AGIS) with pointwise linear regression (PLR) analysis of serial VFs.DesignProspective, multicenter, randomized clinical trial.ParticipantsFive hundred nine eyes of 401 patients from the AGIS with a baseline VF score of or=7 VF examinations, and >or=3 years of follow-up were selected.Main Outcome MeasureVisual field progression.MethodsThis is a cohort study of patients enrolled in a prospective randomized clinical trial (AGIS). Worsening of a test location on PLR analysis was defined as a change of threshold sensitivity of >or=1.00 decibels a year, with PResultsThe mean (+/- standard deviation) follow-up time and baseline AGIS score were 7.4 (+/-1.7) years and 7.7 (+/-4.4), respectively. Visual field progression was detected with PLR analysis in 151 eyes (30%). Older age at the initial intervention (P = 0.0012; odds ratio [OR], 1.30; 95% confidence interval [CI], 1.11-1.50), larger IOP fluctuation (P = 0.0013; OR, 1.31; 95% CI, 1.12-1.54), increasing number of glaucoma interventions (P = 0.01; OR, 1.74; 95% CI, 1.14-2.64), and longer follow-up (P = 0.02; OR, 1.19; 95% CI, 1.03-1.38) were associated with increased odds of VF progression. When regression analyses were repeated in eyes with and without a history of cataract extraction, IOP fluctuation was the only variable to be consistently associated with VF progression.ConclusionBoth increasing age and greater IOP fluctuation increase the odds of VF progression by 30% (for each 5-year increment in age and 1-mmHg increase in IOP fluctuation). The higher risk conferred by IOP fluctuation was consistently observed in eyes with and without a history of cataract extraction.