title: Blindness and long-term progression of visual field defects in chinese patients with primary angle-closure glaucoma.
abstract: OBJECTIVE
  To investigate the long-term rates of blindness and visual field (VF) progression in treated primary angle-closure glaucoma (PACG) patients.
  
  
  METHODS
  Retrospective observational case series.
  
  
  METHODS
  PACG patients with ≥10 years of follow-up were analyzed. All VFs (static automated perimetry, central 24-2 threshold test) performed were reviewed and reliable VFs (fixation losses <20%, false positives and false negatives <33%) were scored using the Advanced Glaucoma Intervention Study (AGIS) system. Progression of a VF defect was defined as a change of ≥4 from baseline on 2 consecutive VF tests.
  
  
  RESULTS
  From the 137 eyes of 87 patients with PACG with ≥10 years of follow-up identified, 6% and 30.1% were blind based on initial visual acuity (VA) and VF criteria respectively and 12.0% had an initial AGIS score of 20; these were excluded. Eighty-three eyes from 57 patients (all Chinese, mean age 59.9 ± 8.2 years, 67.5% female) were analyzed. The mean AGIS score was 5.14 ± 4.37 at baseline. VF deterioration was detected in 27 eyes (32.5%) of 21 patients, with 4.8% and 7.2% of eyes progressing to blindness based on VA and VF criteria respectively. On Cox regression, eyes with VF progression had higher mean overall IOP (P < .001), and higher prevalence of previous acute angle closure (AAC, P = .008).
  
  
  CONCLUSIONS
  Over 10 years, a third of PACG patients were found to have VF progression, with 7% progressing to blindness while on treatment. Eyes with higher mean overall IOP and a history of previous AAC were more likely to have VF progression.
authors.affiliation: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
authors.forename: Desmond T L
authors.initials: DTL
authors.lastname: Quek
authors.affiliation: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
authors.forename: Victor T
authors.initials: VT
authors.lastname: Koh
authors.affiliation: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
authors.forename: Gavin S
authors.initials: GS
authors.lastname: Tan
authors.affiliation: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore.
authors.forename: Shamira A
authors.initials: SA
authors.lastname: Perera
authors.affiliation: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Tina T
authors.initials: TT
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute and Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. Electronic address: tin11@pacific.net.sg.
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
mesh_terms: D044466:Asian People / Q000706:statistics & numerical data*; D001766:Blindness / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015812:Glaucoma, Angle-Closure / Q000453:epidemiology / Q000503:physiopathology*; D006068:Gonioscopy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000453:epidemiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*