Long-term clinical course of normotensive preperimetric glaucoma

Br J Ophthalmol. 2017 Dec;101(12):1649-1653. doi: 10.1136/bjophthalmol-2016-309401. Epub 2017 Apr 17.

Abstract

Aims: To evaluate the long-term clinical course of normotensive preperimetric glaucoma (PPG).

Methods: We retrospectively analysed 130 eyes of 130 patients initially diagnosed as having preperimetric normal tension glaucoma and followed these cases for at least 5 years with reliable visual field (VF) examinations by standard automated perimetry. When the VF defect (VFD) met Anderson-Patella's criteria on three or more consecutive examinations, and consistently met the criteria on subsequent examinations, we concluded that a glaucomatous VFD was present. Predictive factors for developing a VFD were assessed.

Results: Seventy-one eyes (54.6%) developed a glaucomatous VFD during the follow-up period. The mean deviation slope varied from -0.90 to 0.41 dB/year. A Cox proportional hazard model showed that having a greater initial pattern SD (p=0.005), the presence of optic disc haemorrhage (p=0.022) and higher mean intraocular pressure (IOP) prior to developing a VFD (p=0.039) were related to developing a VFD.

Conclusions: Our findings confirmed that the mean IOP, but not the IOP fluctuation, is strongly associated with the development of a VFD in cases of PPG.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Intraocular Pressure
  • Low Tension Glaucoma / complications
  • Low Tension Glaucoma / diagnosis*
  • Low Tension Glaucoma / physiopathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Scotoma / diagnosis*
  • Scotoma / etiology
  • Scotoma / physiopathology
  • Time Factors
  • Visual Field Tests
  • Visual Fields / physiology*
  • Young Adult