title: Risk factors for glaucoma onset and progression.
abstract: In this review, we distinguish among risk factors associated with the development of open-angle glaucoma in individuals with healthy eyes, predictive determinants for the development of open-angle glaucoma in subjects with ocular hypertension, and prognostic factors for the progression of open-angle glaucoma in individuals who already have the disease. We primarily reviewed recent longitudinal population-based epidemiological studies, prospectively planned clinical trials, and cohort studies. Risk factors consistently associated with the development of open-angle glaucoma in individuals with healthy eyes include older age and an approximately 1 mm Hg increase in intraocular pressure (IOP) at baseline. Family history for open-angle glaucoma may be associated with the development of open-angle glaucoma as well. Predictive factors for the development of open-angle glaucoma in individuals with ocular hypertension may be older age, thinner central corneal thickness, higher cup-to-disk ratios of the optic disc, and higher pattern standard deviation values on the Humphrey automated perimeter at baseline. Given multi-center trials that showed similar predictive factors for the development of open-angle glaucoma in individuals with ocular hypertension, a calculator is available to clinicians for assessing the 5-year likelihood of developing open-angle glaucoma in ocular hypertensive patients with certain characteristics. Prognostic factors for the progression of open-angle glaucoma in individuals who already have the condition include older age at baseline, higher IOP at baseline, and thinner central conreal thickness. Self-report of diabetes may be associated with open-angle glaucoma progression. In conclusion, the only modifiable factor associated with open-angle glaucoma that has been consistently identified is elevated baseline IOP. Future research needs to evaluate the importance of others modifiable factors such as IOP fluctuation or nutritional factors.
authors.affiliation: Frances and Ray Stark Professor of Ophthalmology and Epidemiology, Jules Stein Eye Institute, David Geffen School of Medicine, UCLA, Los Angeles, California 90095, USA.
authors.forename: Anne L
authors.initials: AL
authors.lastname: Coleman
authors.forename: Stefano
authors.initials: S
authors.lastname: Miglior
mesh_terms: D018450:Disease Progression; D005902:Glaucoma, Open-Angle / Q000209:etiology* / Q000503:physiopathology*; D006801:Humans; D009798:Ocular Hypertension / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors