Relationship between visual field progression and baseline refraction in primary open-angle glaucoma

Tomoko Naito; Keiji Yoshikawa; Shiro Mizoue; Mami Nanno; Tairo Kimura; Hirotaka Suzumura; Yuzo Umeda; Fumio Shiraga

doi:10.2147/OPTH.S109732

Relationship between visual field progression and baseline refraction in primary open-angle glaucoma

Clin Ophthalmol. 2016 Jul 28:10:1397-403. doi: 10.2147/OPTH.S109732. eCollection 2016.

Authors

Tomoko Naito¹, Keiji Yoshikawa², Shiro Mizoue³, Mami Nanno⁴, Tairo Kimura⁵, Hirotaka Suzumura⁶, Yuzo Umeda⁷, Fumio Shiraga¹

Affiliations

¹ Department of Ophthalmology, Okayama University Graduate School of Medicine, Okayama, Japan.
² Yoshikawa Eye Clinic, Tokyo, Japan.
³ Department of Ophthalmology, Ehime University Graduate School of Medicine, Ehime, Japan.
⁴ Kagurazaka Minamino Eye Clinic.
⁵ Ueno Eye Clinic.
⁶ Suzumura Eye Clinic, Tokyo, Japan.
⁷ Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan.

Abstract

Purpose: To analyze the relationship between visual field (VF) progression and baseline refraction in Japanese patients with primary open-angle glaucoma (POAG) including normal-tension glaucoma.

Patients and methods: In this retrospective study, the subjects were patients with POAG who had undergone VF tests at least ten times with a Humphrey Field Analyzer (Swedish interactive thresholding algorithm standard, Central 30-2 program). VF progression was defined as a significantly negative value of mean deviation (MD) slope at the final VF test. Multivariate logistic regression models were applied to detect an association between MD slope deterioration and baseline refraction.

Results: A total of 156 eyes of 156 patients were included in this analysis. Significant deterioration of MD slope was observed in 70 eyes of 70 patients (44.9%), whereas no significant deterioration was evident in 86 eyes of 86 patients (55.1%). The eyes with VF progression had significantly higher baseline refraction compared to those without apparent VF progression (-1.9±3.8 diopter [D] vs -3.5±3.4 D, P=0.0048) (mean ± standard deviation). When subject eyes were classified into four groups by the level of baseline refraction applying spherical equivalent (SE): no myopia (SE > -1D), mild myopia (-1D ≥ SE > -3D), moderate myopia (-3D ≥ SE > -6D), and severe myopia (-6D ≥ SE), the Cochran-Armitage trend analysis showed a decreasing trend in the proportion of MD slope deterioration with increasing severity of myopia (P=0.0002). The multivariate analysis revealed that baseline refraction (P=0.0108, odds ratio [OR]: 1.13, 95% confidence interval [CI]: 1.03-1.25) and intraocular pressure reduction rate (P=0.0150, OR: 0.97, 95% CI: 0.94-0.99) had a significant association with MD slope deterioration.

Conclusion: In the current analysis of Japanese patients with POAG, baseline refraction was a factor significantly associated with MD slope deterioration as well as intraocular pressure reduction rate. When baseline refraction was classified into four groups, MD slope in myopia groups was less deteriorated as compared to those in the emmetropic/hyperopic group.

Keywords: MD slope; intraocular pressure reduction rate; myopia; normal-tension glaucoma; primary open-angle glaucoma; refraction; visual field progression.