title: Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years.
abstract: OBJECTIVE
  To determine the proportion of blindness and investigate the relationships between risk factors based on clinical characteristics and development of blindness in patients with primary open-angle glaucoma (POAG) treated for at least 15 years.
  
  
  METHODS
  A retrospective observational chart review was performed with 403 patients referred to a tertiary level hospital, each with a diagnosis of primary open-angle glaucoma, treated for at least 15 years. Blindness attributable to glaucoma was defined based on visual acuity and/or visual field tests. Variables considered to be possible risk factors for blindness were evaluated using odds ratio (OR), confidence interval (95% CI), and univariate and multivariate analyses.
  
  
  RESULTS
  Thirty-one patients became blind [13/53 (24.5%) - unilaterally and 18/53 (34%) - bilaterally] during the follow-up period of treatment (19.5 ± 4.6 years, range 15-31 years). Multivariate statistics with regression analysis revealed that persistency on initial therapy ≤6 months was significantly associated with blindness, both unilateral (OR: 8.4; 95% CI: 1.3-56.4) and bilateral (OR: 7.2; 95% CI: 1.3-39.6). Other potential factors such as race, age, gender or number of medications were not associated with blindness.
  
  
  CONCLUSIONS
  Blindness from primary open-angle glaucoma was not uncommon in this population of treated patients after the long follow-up period proposed. Persistence rates with the first therapy, as measured by a medical decision to change, were low. Persistence ≤6 months was statistically associated with the development of unilateral and bilateral blindness from glaucoma.
authors.affiliation: Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto FMRP - Universidade de São Paulo - Ribeirão Preto (SP), Brazil.
authors.forename: Jayter Silva
authors.initials: JS
authors.lastname: Paula
authors.forename: João Marcello
authors.initials: JM
authors.lastname: Furtado
authors.forename: Arles Silva
authors.initials: AS
authors.lastname: Santos
authors.forename: Roberto de Mattos
authors.initials: Rde M
authors.lastname: Coelho
authors.forename: Eduardo Melani
authors.initials: EM
authors.lastname: Rocha
authors.forename: Maria de Lourdes Veronese
authors.initials: Mde L
authors.lastname: Rodrigues
mesh_terms: D000328:Adult; D001766:Blindness / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005902:Glaucoma, Open-Angle / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity; D014794:Visual Fields