Factors Associated with 5-year Glaucomatous Progression in Glaucoma Suspect Eyes: A Retrospective Longitudinal Study

Nariman Nassiri; Shibandri Das; Vaama Patel; Aravindh Nirmalan; Dhir Patwa; Alexandra Heriford; Chaesik Kim; Haoxing Chen; Faisal Ridha; Justin Tannir; Anju Goyal; Mark S Juzych; Bret A Hughes

doi:10.5005/jp-journals-10078-1350

Factors Associated with 5-year Glaucomatous Progression in Glaucoma Suspect Eyes: A Retrospective Longitudinal Study

J Curr Glaucoma Pract. 2022 Jan-Apr;16(1):11-16. doi: 10.5005/jp-journals-10078-1350.

Authors

Affiliations

¹ Ophthalmology, Kresge Eye Institute, Wayne State University School of Medicine, Detroit, Michigan, United States.
² Wayne State University School of Medicine, Detroit, Michigan, United States.
³ Michigan State University, College of Osteopathic Medicine, East Lansing, Michigan, United States.
⁴ John D. Dingell VA Medical Center, Wayne State University School of Medicine, Detroit, Michigan, United States.

Abstract

Purpose: Using demographic, clinical, visual field, and optical coherence tomography (OCT) variables to study the association of 5-year glaucomatous progression in glaucoma suspect eyes.

Patients and methods: This is a retrospective longitudinal clinical study. Inclusion criteria consisted of glaucoma suspect eyes (i.e., concerning cup-to-disk ratio and/or intraocular pressure (IOP) >21 mm Hg), age ≥ 30 years old, follow-up time of 5 years, best-corrected visual acuity (BCVA) of 20/100 or better, spherical equivalent (SE) higher than 8 diopters and an astigmatism less than 3 diopters. Eyes with glaucoma-determined by two consecutive, reliable visual field tests-were excluded, as well as any eyes with any clinically significant retinal or neurological disease. The percentage of glaucoma suspect eyes, which progressed to glaucoma within a 5-year period, was calculated. Study subjects were divided into the following groups: eyes that progressed to glaucoma and those that did not.

Results: In the 288 patients which we looked at, 365 total eyes, 323 eyes had concerning cup-to-disk ratio and 42 had ocular hypertension. Bivariate analysis showed that the eyes which progressed to glaucoma had significantly worse mean deviation, increased pattern standard deviation (PSD), and less visual field index (VFI). Our bivariate analysis also showed a thinner average, superior and inferior retinal nerve fiber layer thickness (RNFL), and more severe average, superior, and inferior RNFL damages (i.e., color grading scale) at baseline. Logistic regression analysis showed that only PSD and severe inferior RNFL damage (i.e., red color) to be significantly associated with 5-year glaucomatous progression.

Conclusion: Segmental RNFL damage and pattern standard deviation are associated with 5-year glaucomatous progression in glaucoma suspect eyes.

How to cite this article: Nassiri N, Das S, Patel V, et al. Factors Associated with 5-year Glaucomatous Progression in Glaucoma Suspect Eyes: A Retrospective Longitudinal Study. J Curr Glaucoma Pract 2022;16(1):11-16.

Keywords: Glaucoma suspect; Glaucomatous progression; Ocular hypertension; Optical coherence tomography (OCT); Retinal nerve fiber layer (RNFL); Risk factors; Visual field; Visual field index.