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Lyu, Lee, and Kee: Risk Factors for Rapid Visual Field Progression in Normal-Tension Glaucoma
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(7): 996-1001.

Published online: 13 July 2012

DOI: https://doi.org/10.3341/jkos.2012.53.7.996

Risk Factors for Rapid Visual Field Progression in Normal-Tension Glaucoma

In Jeong Lyu, MD, Jung Min Lee, MD, Changwon Kee, MD, PhD

Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address reprint requests to Changwon Kee, MD, PhD. Department of Ophthalmology, Samsung Medical Center, #81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-3564, Fax: 82-2-3410-0074, cwkee@smc.samsung.co.kr

Received 15 November 2011       Accepted 4 May 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate risk factors of rapid visual field progression in normal-tension glaucoma.

Methods

The authors of the present study reviewed the medical records of patients with normal-tension glaucoma who were treated between 2001 and 2011. The rapid progression group was composed of patients who showed a visual field index progression rate of ≤ -2.0%/yr, and the slow progression group was composed of patients who showed a visual field index progression rate of > -1.0%/yr using a Humphrey visual field analyzer (HFA). Age, sex, diabetes, hypertension, migraine history, family history of glaucoma, refractive error, central corneal thickness, disc hemorrhage, beta-zone parapapillary atrophy, baseline mean deviation, pattern standard deviation, initial IOP, mean follow-up IOP, peak IOP, IOP fluctuation, and number of eye drops between the 2 groups were compared.

Results

Among the 52 patients with normal-tension glaucoma, 26 were classified into the rapid progression group and 26 were classified into the slow progression group. The mean visual field index progression rate was -3.92%/yr and -0.42%/yr, respectively. In the univariable model, migraine history, disc hemorrhage, beta-zone parapapillary atrophy, and number of eye drops were associated with rapid visual field progression. According to multivariate analysis, disc hemorrhage and number of eye drops were statistically significant risk factors.

Conclusions

Disc hemorrhage and number of eye drops were associated with rapid visual field progression in normal tension glaucoma patients.

Keywords: Normal-tension glaucoma, Progression, Visual field, Visual field index

Figures and Tables

Table 1
Demographic characteristics of the study population
jkos-53-996-i001

Values are presented as mean ± SD.

VF = visual field; CCT = central corneal thickness; MD = mean deviation; IOP = intraocular pressure; VFI = visual field index.

*Independent t-test.

Table 2
Logistic regression testing the association between all baseline and intercurrent factors with a progression outcome
jkos-53-996-i002

CI = confidence interval; MD = mean deviation; PSD = pattern standard deviation; βPPA = beta-zone PPA; IOP = intraocular pressure; OR = odds ratio; SD = standard deviation.

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