title: Risk factors for visual field progression in treated glaucoma.
abstract: OBJECTIVE
  To determine intraocular pressure (IOP)-dependent and IOP-independent variables associated with visual field (VF) progression in treated glaucoma.
  
  
  METHODS
  Retrospective cohort of the Glaucoma Progression Study.
  
  
  METHODS
  Consecutive, treated glaucoma patients with repeatable VF loss who had 8 or more VF examinations of either eye, using the Swedish Interactive Threshold Algorithm (24-2 SITA-Standard, Humphrey Field Analyzer II; Carl Zeiss Meditec, Inc, Dublin, California), during the period between January 1999 and September 2009 were included. Visual field progression was evaluated using automated pointwise linear regression. Evaluated data included age, sex, race, central corneal thickness, baseline VF mean deviation, mean follow-up IOP, peak IOP, IOP fluctuation, a detected disc hemorrhage, and presence of beta-zone parapapillary atrophy.
  
  
  RESULTS
  We selected 587 eyes of 587 patients (mean [SD] age, 64.9 [13.0] years). The mean (SD) number of VFs was 11.1 (3.0), spanning a mean (SD) of 6.4 (1.7) years. In the univariable model, older age (odds ratio [OR], 1.19 per decade; P = .01), baseline diagnosis of exfoliation syndrome (OR, 1.79; P = .01), decreased central corneal thickness (OR, 1.38 per 40 μm thinner; P < .01), a detected disc hemorrhage (OR, 2.31; P < .01), presence of beta-zone parapapillary atrophy (OR, 2.17; P < .01), and all IOP parameters (mean follow-up, peak, and fluctuation; P < .01) were associated with increased risk of VF progression. In the multivariable model, peak IOP (OR, 1.13; P < .01), thinner central corneal thickness (OR, 1.45 per 40 μm thinner; P < .01), a detected disc hemorrhage (OR, 2.59; P < .01), and presence of beta-zone parapapillary atrophy (OR, 2.38; P < .01) were associated with VF progression.
  
  
  CONCLUSIONS
  IOP-dependent and IOP-independent risk factors affect disease progression in treated glaucoma. Peak IOP is a better predictor of progression than is IOP mean or fluctuation.
authors.affiliation: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, 310 E 14th St, New York, NY 10003, USA.
authors.forename: Carlos Gustavo V
authors.initials: CG
authors.lastname: De Moraes
authors.forename: Viral J
authors.initials: VJ
authors.lastname: Juthani
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Liebmann
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Teng
authors.forename: Celso
authors.initials: C
authors.lastname: Tello
authors.forename: Remo
authors.initials: R
authors.lastname: Susanna
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
mesh_terms: D000465:Algorithms; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009898:Optic Disk / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis / Q000503:physiopathology*; D058609:Visual Field Tests; D014794:Visual Fields