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Prediction of functional loss in glaucoma from progressive optic disc damage.

Publication ,  Journal Article
Medeiros, FA; Alencar, LM; Zangwill, LM; Bowd, C; Sample, PA; Weinreb, RN
Published in: Arch Ophthalmol
October 2009

OBJECTIVE: To evaluate the ability of progressive optic disc damage detected by assessment of longitudinal stereophotographs to predict future development of functional loss in those with suspected glaucoma. METHODS: The study included 639 eyes of 407 patients with suspected glaucoma followed up for an average of 8.0 years with annual standard automated perimetry visual field and optic disc stereophotographs. All patients had normal and reliable standard automated perimetry results at baseline. Conversion to glaucoma was defined as development of 3 consecutive abnormal visual fields during follow-up. Presence of progressive optic disc damage was evaluated by grading longitudinally acquired simultaneous stereophotographs. Other predictive factors included age, intraocular pressure, central corneal thickness, pattern standard deviation, and baseline stereophotograph grading. Hazard ratios for predicting visual field loss were obtained by extended Cox models, with optic disc progression as a time-dependent covariate. Predictive accuracy was evaluated using a modified R(2) index. RESULTS: Progressive optic disc damage had a hazard ratio of 25.8 (95% confidence interval, 16.0-41.7) and was the most important risk factor for development of visual field loss with an R(2) of 79%. The R(2)s for other predictive factors ranged from 6% to 26%. CONCLUSIONS: Presence of progressive optic disc damage on stereophotographs was a highly predictive factor for future development of functional loss in glaucoma. These findings suggest the importance of careful monitoring of the optic disc appearance and a potential role for longitudinal assessment of the optic disc as an end point in clinical trials and as a reference for evaluation of diagnostic tests in glaucoma.

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Published In

Arch Ophthalmol

DOI

EISSN

1538-3601

Publication Date

October 2009

Volume

127

Issue

10

Start / End Page

1250 / 1256

Location

United States

Related Subject Headings

  • Visual Fields
  • Visual Field Tests
  • Visual Acuity
  • Vision Disorders
  • Risk Factors
  • Reproducibility of Results
  • Prospective Studies
  • Photography
  • Optic Nerve Diseases
  • Optic Disk
 

Citation

APA
Chicago
ICMJE
MLA
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Medeiros, F. A., Alencar, L. M., Zangwill, L. M., Bowd, C., Sample, P. A., & Weinreb, R. N. (2009). Prediction of functional loss in glaucoma from progressive optic disc damage. Arch Ophthalmol, 127(10), 1250–1256. https://doi.org/10.1001/archophthalmol.2009.276
Medeiros, Felipe A., Luciana M. Alencar, Linda M. Zangwill, Christopher Bowd, Pamela A. Sample, and Robert N. Weinreb. “Prediction of functional loss in glaucoma from progressive optic disc damage.Arch Ophthalmol 127, no. 10 (October 2009): 1250–56. https://doi.org/10.1001/archophthalmol.2009.276.
Medeiros FA, Alencar LM, Zangwill LM, Bowd C, Sample PA, Weinreb RN. Prediction of functional loss in glaucoma from progressive optic disc damage. Arch Ophthalmol. 2009 Oct;127(10):1250–6.
Medeiros, Felipe A., et al. “Prediction of functional loss in glaucoma from progressive optic disc damage.Arch Ophthalmol, vol. 127, no. 10, Oct. 2009, pp. 1250–56. Pubmed, doi:10.1001/archophthalmol.2009.276.
Medeiros FA, Alencar LM, Zangwill LM, Bowd C, Sample PA, Weinreb RN. Prediction of functional loss in glaucoma from progressive optic disc damage. Arch Ophthalmol. 2009 Oct;127(10):1250–1256.

Published In

Arch Ophthalmol

DOI

EISSN

1538-3601

Publication Date

October 2009

Volume

127

Issue

10

Start / End Page

1250 / 1256

Location

United States

Related Subject Headings

  • Visual Fields
  • Visual Field Tests
  • Visual Acuity
  • Vision Disorders
  • Risk Factors
  • Reproducibility of Results
  • Prospective Studies
  • Photography
  • Optic Nerve Diseases
  • Optic Disk