Journal of Current Glaucoma Practice

Register      Login

VOLUME 16 , ISSUE 1 ( January-April, 2022 ) > List of Articles


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

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

Citation Information : Nassiri N, Das S, Patel V, Nirmalan A, Patwa D, Heriford A, Kim C, Chen H, Ridha F, Tannir J, Goyal A, Juzych MS, Hughes BA. Factors Associated with 5-year Glaucomatous Progression in Glaucoma Suspect Eyes: A Retrospective Longitudinal Study. J Curr Glaucoma Pract 2022; 16 (1):11-16.

DOI: 10.5005/jp-journals-10078-1350

License: CC BY-NC 4.0

Published Online: 03-05-2022

Copyright Statement:  Copyright © 2022; The Author(s).


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.

PDF Share
  1. Gordon MO, Beiser JA, Brandt JD, et al. The ocular hypertensive treatment study: baseline factors that predict the onset of primary open-angle glaucoma. Arch Ophthalmol 2002;120(6):714–720. DOI: 10.1001/archopht.120.6.714
  2. Tielsch JM, Katz J, Sommer A, et al. Family history and risk of primary open-angle glaucoma: the Baltimore eye study. Arch Ophthalmol 1994;112(1):69–73. DOI: 10.1001/archopht.1994.01090130079022
  3. Mitchell P, Smith W, Chey T, et al. Open angle glaucoma and diabetes. Ophthalmology 1997;104(4):712–718. DOI: 10.1016/s0161-6420(97)30247-4
  4. Mitchell P, Lee AJ, Rochtchina E, et al. Open-angle glaucoma and systemic hypertension: the Blue Mountains eye study. J Glaucoma 2004;13(4):319–326. DOI: 10.1097/00061198-200408000-00010
  5. Drance S, Anderson DR, Schulzer M, et al. Risk factors for progression of visual field abnormalities in normal- tension glaucoma. Am J Ophthalmol 2001;131(6):699–708. DOI: 10.1016/s0002-9394(01)00964-3
  6. Mitchell P, Hourihan F, Sandbach J, et al. The relationship between glaucoma and myopia: the Blue Mountains eye study. Ophthalmology 1999;106(10):2010–2015. DOI: 10.1016/s0161-6420(99)90416-5
  7. Landers J, Martin K, Sarkies N, et al. A 20 year follow-up study of trabeculectomy: risk factors and outcomes. Ophthalmology 2012;119(4):694–702. DOI: 10.1016/j.ophtha.2011.09.043
  8. Kass MA, Heuer DK, Higginbotham EJ, et al. The ocular hypertension treatment study. A randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol 2002;120(6):701–713; discussion 829–830. DOI: 10.1001/archopht.120.6.701
  9. Moyer VA, U.S. Preventive Services Task Force. Screening for glaucoma: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 2013;159(7):484–489. DOI: 10.7326/0003-4819-159-6-201309170-00686
  10. Anderson DR, Patella VM. Automated static perimetry. St. Louis: Mosby; 1999.
  11. Miglior S, Pfeiffer N, Torri V, et al. Predictive factors for open-angle glaucoma among patients with ocular hypertension in the European Glaucoma Prevention Study. Ophthalmology 2007;114(1):3–9. DOI: 10.1016/j.ophtha.2006.05.075
  12. Brandt JD, Gordon MO, Gao F, et al. Ocular hypertension treatment study group. Adjusting intraocular pressure for central corneal thickness does not improve prediction models for primary open-angle glaucoma. Ophthalmology 2012;119(3):437–442. DOI: 10.1016/j.ophtha.2011.03.018
  13. Budenz DL, Huecker JB, Gedde SJ, et al. Ocular hypertension treatment study group. Thirteen-year follow-up of optic disk hemorrhages in the Ocular Hypertension Treatment Study. Am J Ophthalmol 2017;174:126–133. DOI: 10.1016/j.ajo.2016.10.023
  14. Sehi M, Zhang X, Greenfield DS, et al. Advanced Imaging for Glaucoma Study Group. Retinal nerve fiber layer atrophy is associated with visual field loss over time in glaucoma suspect and glaucomatous eyes. Am J Ophthalmol 2013;155(1):73–82.e1. DOI: 10.1016/j.ajo.2012.07.005
  15. Artes PH, Chauhan BC. Longitudinal changes in the visual field and optic disk in glaucoma. Prog Retin Eye Res 2005;24(3):333–354. DOI: 10.1016/j.preteyeres.2004.10.002
  16. Greenfield DS. Optic nerve and retinal nerve fiber layer analyzers in glaucoma. Curr Opin Ophthalmol 2002;13(2):68–76. DOI: 10.1097/00055735-200204000-00003
  17. Zhu H, Crabb DP, Fredette MJ, et al. Quantifying discordance between structure and function measurements in the clinical assessment of glaucoma. Arch Ophthalmol 2011;129(9):1167–1174. DOI: 10.1001/archophthalmol.2011.112
  18. Zhu H, Crabb DP, Schlottmann PG, et al. Predicting visual function from the measurements of retinal nerve fiber layer structure. Invest Ophthalmol Vis Sci 2010;51(11):5657–5666. DOI: 10.1167/iovs.10-5239
  19. Falsini B, Marangoni D, Salgarello T, et al. Structure-function relationship in ocular hypertension and glaucoma: interindividual and interocular analysis by OCT and pattern ERG. Graefes Arch Clin Exp Ophthalmol 2008;246(8):1153–1162. DOI: 10.1007/s00417-008-0808-5
  20. Strouthidis NG, Vinciotti V, Tucker AJ, et al. Structure and function in glaucoma: the relationship between a functional visual field map and an anatomic retinal map. Invest Ophthalmol Vis Sci 2006;47(12):5356–5362. DOI: 10.1167/iovs.05-1660
  21. Harwerth RS, Quigley HA. Visual field defects and retinal ganglion cell losses in patients with glaucoma. Arch Ophthalmol 2006;124(6):853–859. DOI: 10.1001/archopht.124.6.853
  22. Johnson CA, Sample PA, Zangwill LM, et al. Structure and function evaluation (SAFE): II. Comparison of optic disk and visual field characteristics. Am J Ophthalmol 2003;135(2):148–154. DOI: 10.1016/s0002-9394(02)01930-x
  23. Johnson CA, Cioffi GA, Liebmann JR, et al. The relationship between structural and functional alterations in glaucoma: a review. Semin Ophthalmol 2000;15(4):221–233. DOI: 10.3109/08820530009037873
  24. Taliantzis S, Papaconstantinou D, Koutsandrea C, et al. Comparative studies of RNFL thickness measured by OCT with global index of visual fields in patients with ocular hypertension and early open angle glaucoma. Clin Ophthalmol 2009;3:373–379. DOI: 10.2147/opth.s6150
  25. Medeiros FA, Alencar LM, Zangwill LM, et al. Prediction of functional loss in glaucoma from progressive optic disk damage. Arch Ophthalmol 2009;127(10):1250–1256. DOI: 10.1001/archophthalmol.2009.276
  26. Lalezary M, Medeiros FA, Weinreb RN, et al. Baseline optical coherence tomography predicts the development of glaucomatous change in glaucoma suspects. Am J Ophthalmol 2006;142(4):576–582. DOI: 10.1016/j.ajo.2006.05.004
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.