ROY W.BECKMD, PhD
To determine systemic and ocular risk factors for visual field progression in open-angle glaucoma.
In the Canadian Glaucoma Study, a multicenter prospective longitudinal study of 258 patients (131 men and 127 women; median age, 65.0 years), baseline systemic measures included assessment of peripheral vasospasm and markers for hematopathology, coagulopathy, and immunopathology. Patients were followed up at 4-month intervals with perimetry, optic disc imaging, and a standardized interventional protocol for intraocular pressure control. Univariate and proportional hazards models were used to identify factors that predicted progression.
Main Outcome Measure
Visual field progression with standard automated perimetry.
Median follow-up was 5.3 years, with 167 patients (64.7%) completing 5 years or more and 67 patients (26.0%) completing 7 years or more. Abnormal baseline anticardiolipin antibody levels (hazard ratio [HR], 3.86; 95% confidence interval [CI], 1.60-9.31), higher baseline age (HR per year, 1.04; 95% CI, 1.01-1.07), female sex (HR, 1.94; 95% CI, 1.09-3.46), and higher mean follow-up intraocular pressure (HR per 1 mm Hg, 1.19; 95% CI, 1.05-1.36) before progression were associated with progression.
The Canadian Glaucoma Study identified 4 independent predictive factors for glaucomatous field progression.
Application to Clinical Practice
While confirming the importance of intraocular pressure in glaucoma progression, this study determined other risk factors that merit awareness.
clinicaltrials.gov Identifier: NCT00262626
Chauhan BC, Mikelberg FS, Balaszi AG, LeBlanc RP, Lesk MR, Trope GE, Canadian Glaucoma Study Group. Canadian Glaucoma Study2. Risk Factors for the Progression of Open-angle Glaucoma. Arch Ophthalmol. 2008;126(8):1030-1036. doi:10.1001/archopht.126.8.1030