title: Portsmouth visual field database: an audit of glaucoma progression.
abstract: OBJECTIVE
  To explore visual field (VF) progression in a cohort of secondary care-treated glaucoma and ocular hypertensive (OHT) patients.
  
  
  METHODS
  We extracted VFs from our database drawn from our normal clinical practice. VF series from 4177 eyes from 2208 patients who had five or more VFs were obtained, the 'better' eye was selected and the rate of VF progression was calculated using mean deviation (MD) data.
  
  
  RESULTS
  The median rate of progression for the whole sample was -0.1 dB/year (interquartile range (IQR) -4 to 0 dB/year) over a median of 6.7 years (IQR 4.9-8.7). Of 2208 patients, 477 (21.2%) progressed at > -0.5 dB/year; 46 (2.1%) progressed at >-2.0 dB/year. Of those with a 'final MD' of worse than -10 dB (N=244) in their better eye; 14.0% were 'fast progressors' (>-2 dB/year), 33.7% 'moderate progressors' (-1 to -2 dB/year), and 28.8% 'slow progressors' (-0.3 dB to -1 dB/year). Of those with 'initial MD' better than -3 dB and those with worse than -3 dB, 31/1679 (1.8%) and 213/529 (40.3%) respectively, had a final MD of worse than -10 dB.
  
  
  CONCLUSIONS
  Fast progressors, while important, are relatively rare. Moderate and slow progressors make up the majority of the progressing population within this data set. The risk of significant visual loss is much higher in those with initial damage. With increasing life expectancy, moderate and slow progressors may become increasingly clinically important.
authors.affiliation: Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: J F
authors.initials: JF
authors.lastname: Kirwan
authors.affiliation: Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: A
authors.initials: A
authors.lastname: Hustler
authors.affiliation: Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: H
authors.initials: H
authors.lastname: Bobat
authors.affiliation: Department of Ophthalmology, Queen Alexandra Hospital, Portsmouth, UK.
authors.forename: L
authors.initials: L
authors.lastname: Toms
authors.affiliation: Department of Optometry and Visual Science, City University London, London, UK.
authors.forename: D P
authors.initials: DP
authors.lastname: Crabb
authors.affiliation: Ophthalmology Department, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham General Hospital, Cheltenham, UK.
authors.forename: A I
authors.initials: AI
authors.lastname: McNaught
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual / Q000706:statistics & numerical data*; D018450:Disease Progression; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008485:Medical Audit / Q000706:statistics & numerical data*; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*