title: Factors associated with visual loss in patients with advanced glaucomatous changes in the optic nerve head.
abstract: We evaluated factors associated with decreased or stable visual function in 72 patients with primary open-angle glaucoma and complete cupping of the optic disk who were followed up five years or more. We found a significantly lower mean (15.4 +/- 2.7 mm Hg) and peak (24.5 +/- 6.9 mm Hg) intraocular pressure in those patients whose vision remained stable vs those whose vision decreased (21.3 +/- 3.2 and 39.2 +/- 11.0 mm Hg, respectively) (t-test, P < .001). Additionally, the variance of each patient's individual intraocular pressure readings measured during the follow-up period was lower in the group with stable vision (4.5 mm Hg) than in those in whom vision decreased (9.0 mm Hg) (F test, P < .001). Stepwise discriminant analysis disclosed that mean intraocular pressure, variance of an individual's intraocular pressure measurements over time, history of argon laser trabeculoplasty, and compliance with therapy discriminated 92.9% of patients (52 of 56) whose vision remained stable and 87.5% of patients (14 of 16) whose vision decreased. Reduction of intraocular pressure and compliance with therapy are important in patients with complete glaucomatous cupping of the optic disk.
authors.affiliation: Glaucoma Service, Medical University of South Carolina, Charleston 29425-2236.
authors.forename: W C
authors.initials: WC
authors.lastname: Stewart
authors.forename: R P
authors.initials: RP
authors.lastname: Chorak
authors.forename: H H
authors.initials: HH
authors.lastname: Hunt
authors.forename: G
authors.initials: G
authors.lastname: Sethuraman
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009898:Optic Disk / Q000503:physiopathology*; D009901:Optic Nerve Diseases / Q000209:etiology / Q000503:physiopathology; D012307:Risk Factors; D014130:Trabeculectomy; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology