title: Progression of visual field loss in open angle glaucoma in the Melbourne Visual Impairment Project.
abstract: OBJECTIVE
  To quantify the progression of visual field loss in participants with open angle glaucoma.
  
  
  METHODS
  Cluster random samples of 3271 participants participated in this study. Each participant underwent a standardized ophthalmic examination, which included intraocular pressure measurement, Humphrey 24-2 Fastpac visual field testing and stereophotography of the optic disc. At baseline 118 participants were identified as possible, probable or definite open angle glaucoma and 74 (62.7%) of these were seen again at the follow-up examination. Progression of visual field loss was defined using three methods: the Advanced Glaucoma Intervention Study criteria, the modified Anderson criteria and the Blumenthal method.
  
  
  RESULTS
  In total, 49% of subjects showed progressive visual field loss with at least one method. The Blumenthal criteria yielded the highest rate of progression (37%), followed by the modified Anderson method (33%) and the Advanced Glaucoma Intervention Study method (16%). The progressive visual field loss was associated with baseline glaucoma status (P = 0.02); 65% of the definite glaucoma progressed, compared with 57% of the probable glaucoma and 25% of the possible glaucoma. Participants who had been previously diagnosed with glaucoma had a higher rate of progression (54%) when compared with those who had not been diagnosed previously (47%). In total, 50% (four of eight) of those receiving glaucoma medication at baseline had progressive visual field loss; all were in the definite glaucoma category.
  
  
  CONCLUSIONS
  Despite use of glaucoma medications the majority of glaucoma patients managed by their regular ophthalmologist experienced progressive visual field loss over a 5-year period.
authors.affiliation: Centre for Eye Research Australia, The University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Mimiwati
authors.initials: M
authors.lastname: Zahari
authors.forename: Bickol N
authors.initials: BN
authors.lastname: Mukesh
authors.forename: Julian L
authors.initials: JL
authors.lastname: Rait
authors.forename: Hugh R
authors.initials: HR
authors.lastname: Taylor
authors.forename: Catherine A
authors.initials: CA
authors.lastname: McCarty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003941:Diagnostic Techniques, Ophthalmological; D018450:Disease Progression; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D014739:Victoria; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D014794:Visual Fields