title: Estimating the rate of progressive visual field damage in those with open-angle glaucoma, from cross-sectional data.
abstract: OBJECTIVE
  To estimate the rate of visual field progression in open-angle glaucoma (OAG) subjects, by using data from population-based cross-sectional studies.
  
  
  METHODS
  Subjects with OAG were identified in nine surveys of randomly sampled populations using standard criteria for glaucomatous optic neuropathy. Subjects were of European, African, Chinese, and Hispanic ethnicity. The measure of OAG damage was the mean deviation (MD) of an automated visual field test (Humphrey Field Analyzer; Carl Zeiss Meditec, Inc., Dublin, CA). The rate of progression was the mean of all subjects' damage in the worse eye divided by an average time since onset. Time since onset was estimated from age-specific prevalence rates.
  
  
  RESULTS
  A total of 1066 subjects with OAG contributed visual field data. The mean worsening in decibels per year was: European-derived, -1.12; Hispanic, -1.26; African-derived, -1.33; and Chinese -1.56 (difference among ethnicities, P = 0.16). The mean duration of disease was lowest among Chinese persons at 10.5 years (95% CI: 8.8-12.6) and was highest in African-derived subjects at 15.4 years (95% CI: 14.6-15.9). The progression rate was not consistently related to age or gender. By combining disease duration and progression rate, the model predicted that 15% or fewer of the worse eyes would reach the end of the field damage scale in the patient's lifetime.
  
  
  CONCLUSIONS
  The estimates of typical worsening per year in the worse eye among subjects with OAG suggested slightly more rapid progression than in some clinic-based studies. The rate did not differ significantly by ethnicity or gender, but was worse in those with known, treated OAG and in pseudophakic subjects.
authors.affiliation: Dana Center for Preventive Ophthalmology and the Glaucoma Service, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
authors.forename: Aimee Teo
authors.initials: AT
authors.lastname: Broman
authors.forename: Harry A
authors.initials: HA
authors.lastname: Quigley
authors.forename: Sheila K
authors.initials: SK
authors.lastname: West
authors.forename: Joanne
authors.initials: J
authors.lastname: Katz
authors.forename: Beatriz
authors.initials: B
authors.lastname: Munoz
authors.forename: Karen
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: James M
authors.initials: JM
authors.lastname: Tielsch
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Jonathan
authors.initials: J
authors.lastname: Crowston
authors.forename: Hugh R
authors.initials: HR
authors.lastname: Taylor
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
authors.forename: M Cristina
authors.initials: MC
authors.lastname: Leske
authors.forename: Boel
authors.initials: B
authors.lastname: Bengtsson
authors.forename: Anders
authors.initials: A
authors.lastname: Heijl
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Foster
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005006:Ethnicity; D005260:Female; D005902:Glaucoma, Open-Angle / Q000208:ethnology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015995:Prevalence; D011336:Probability; D012307:Risk Factors; D012737:Sex Factors; D014786:Vision Disorders / Q000208:ethnology / Q000503:physiopathology*; D014794:Visual Fields