Fast Global, Central Visual Field Progression Observed in Routine Glaucoma Care

Approximately 12.5% of eyes with glaucoma undergoing routine treatment demonstrate fast global visual field (VF) progression, and a similar proportion exhibit fast central VF progression (11.7%), according to research published in Ophthalmology. 

Researchers included 461 adults (mean age, 66 years; 50% women) with glaucoma receiving routine care during a median 4.5 year period in the retrospective analysis. The study sample included participants from a private ophthalmology practice and individuals from the Diagnostic Innovations in Glaucoma Study (DIGS; ClinicalTrials.gov Identifier: NCT00221897) and the African Descent and Glaucoma Evaluation Study (ADAGES; ClinicalTrials.gov Identifier: NCT00221923). Among the cohort, 627 (90%) eyes had primary open angle glaucoma (POAG) and 18 (6%) eyes had primary angle closure glaucoma. All participants had at least 5 reliable 24-2 VF tests within a 1- to 5-year period.

Based on the global measure of mean deviation (MD) and the mean total deviation values of the 12 locations in the central 10° region (MTD₁₀), 12.5% and 11.7% of the eyes, respectively, showed a rate of change that was faster than -1.0dB per year — a rate that indicates fast progression for MD values. A total of 29.0% of eyes demonstrated a change faster than -0.5dB per year for MTD₁₀. In addition, 12.7% and 9.1% of the eyes showed a rate of change that exceeded the 1% cut-off of the estimated normal distribution for MD and MTD, respectively, according to the report.

“This study found that approximately one in eight eyes with glaucoma under routine care exhibited fast progression (< -1.0dB/year),” according to the study authors. “Importantly, a similar proportion of eyes exhibited a rate of progression of their central visual field that also exceeded this rate, and nearly one in three eyes showed a < -0.5dB/year decline centrally. These findings underscore the importance of assessing central vision in the clinical management of glaucoma, and the need for new therapies for the notable proportion of fast progressors to prevent functional disability.”

Study limitations include the overrepresentation of patients with POAG in the study sample, and retroscopic nature. 

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies.  Please see the original reference for a full list of authors’ disclosures.