title: Visual field progression outcomes in glaucoma subtypes.
abstract: OBJECTIVE
  To determine whether glaucoma subtype is an independent risk factor for visual field (VF) progression.
  
  
  METHODS
  We reviewed the charts of glaucoma suspects and glaucoma patients seen in a referral practice between 1999 and 2009. Automated pointwise linear regression analysis determined the rates of VF change. A progression endpoint was determined when two or more adjacent test locations in the same hemifield showed a threshold sensitivity decline at a rate of ≥1.0 dB/year with p < 0.01.
  
  
  RESULTS
  We included 841 eyes (841 patients; mean age, 64.1 ± 12.6 years; mean number of VF tests, 10.8 ± 2.8; mean follow-up, 6.4 ± 1.7 years). The glaucomatous group consisted of angle-closure glaucoma (76 eyes), juvenile primary open-angle glaucoma (37 eyes), normal-tension glaucoma (81 eyes), pigmentary glaucoma (34 eyes), primary open-angle glaucoma (275 eyes) and exfoliative glaucoma (XFG, 84 eyes). Normal-tension glaucoma eyes were more likely to present with beta-zone parapapillary atrophy and disc haemorrhage (p < 0.01). Exfoliative glaucoma eyes had the fastest rates of global VF change (-0.65 dB/year), as well as the highest mean, fluctuation, and peak intraocular pressure during follow-up (16.5, 3.0 and 22.0 mmHg, respectively) and reached a progression endpoint more frequently (40%). After adjusting for all covariates, including the glaucoma phenotype, there was no difference among groups regarding global rates of VF change and the risk of reaching a progression endpoint.
  
  
  CONCLUSIONS
  Despite different clinical features, epidemiology and genetics, glaucoma phenotype is not an independent risk factor for VF progression. Rather, variations in well-known, reported risk factors remain important disease parameters that affect progression.
authors.affiliation: Einhorn Clinical Research Center, New York Eye and Ear Infirmary, New York, NY, USA. demoraesmd@gmail.com
authors.forename: Carlos Gustavo
authors.initials: CG
authors.lastname: De Moraes
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Liebmann
authors.forename: Craig A
authors.initials: CA
authors.lastname: Liebmann
authors.forename: Remo
authors.initials: R
authors.lastname: Susanna
authors.forename: Celso
authors.initials: C
authors.lastname: Tello
authors.forename: Robert
authors.initials: R
authors.lastname: Ritch
mesh_terms: D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000145:classification* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012189:Retrospective Studies; D012307:Risk Factors; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields