title: Results of long-term monitoring of normal-tension glaucoma patients receiving medical therapy: results of an 18-year follow-up.
abstract: OBJECTIVE
  To conduct a ≥15-year follow-up assessment of the visual field (VF) in normal-tension glaucoma (NTG) patients receiving medical therapy and to identify risk factors for VF progression.
  
  
  METHODS
  A retrospective clinical study.
  
  
  METHODS
  Medical records of 78 eyes of 78 NTG patients monitored for ≥15 years were reviewed. VF progression was defined by a mean deviation (MD) deteriorated twice by 3.00 dB from baseline (MD criterion) and an annual decrease in the MD slope exceeding -0.5 dB/year (MD slope criterion). Logistic regression analysis was employed to identify risk factors for VF progression.
  
  
  RESULTS
  The mean follow-up period was 18.3 years. The average intraocular pressure (IOP) before treatment was 15.1 ±1.9 mmHg and the average treated IOP was 13.5 ±1.5 mmHg with 2.0 medications. Forty-two eyes (53.8%) showed VF progression using the MD criterion and 15 eyes (19.2%) showed a negative MD slope less than -0.5 dB/year. Disc hemorrhage (DH) was observed in 30 eyes (38.5%). The mean VF progression rate was -0.38 ±0.30 dB/year in the DH group and -0.24 ±0.28 dB/year in the non-DH group (P = 0.012). Multiple logistic regression analysis identified DH [relative risk (RR) 4.28; P = 0.028] as a risk factor for VF progression using the MD criterion. DH (RR 8.77; P = 0.007) and IOP fluctuation during follow-up (RR 5.03; P = 0.048) were detected as risk factors using the MD slope criterion.
  
  
  CONCLUSIONS
  DH and IOP fluctuation were associated with VF progression in NTG during long-term therapy.
authors.affiliation: Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Japan, 501-1194.
authors.forename: Shinya
authors.initials: S
authors.lastname: Komori
authors.forename: Kyoko
authors.initials: K
authors.lastname: Ishida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects / Q000502:physiology; D057066:Low Tension Glaucoma / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D012307:Risk Factors; D014065:Tonometry, Ocular; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents