title: Long-term follow-up in preperimetric open-angle glaucoma: progression rates and associated factors.
abstract: OBJECTIVE
  To investigate the rate of progressive visual field (VF) loss and associated factors for structural or functional progression in preperimetric open-angle glaucoma (OAG).
  
  
  METHODS
  Longitudinal, observational study.
  
  
  METHODS
  We included 127 eyes of 127 preperimetric OAG patients who were treated with topical medication and followed for more than 5 years. All patients underwent stereo optic disc photography, red-free retinal nerve fiber layer (RNFL) photography, frequency doubling technology perimetry, and standard automated perimetry (SAP). Progression was defined as a structural (glaucomatous change confirmed by stereo optic disc and red-free RNFL photography) or functional (new glaucomatous defect on SAP) deterioration. The progression rate of SAP mean deviation (dB/year) and factors associated with progression were evaluated.
  
  
  RESULTS
  Glaucoma progression was detected in 72 of 127 eyes (56.7%). Mean rate of VF progression was -0.39 ± 0.64 dB/year in all patients; -0.66 ± 0.60 dB/year in progressors and -0.03 ± 0.24 dB/year in nonprogressors. A multivariate Cox proportional hazard model revealed that optic disc hemorrhage (hazard ratio [HR] = 1.718, P = .031) and the percentage reduction in intraocular pressure (IOP; HR = 0.964, P = .002) were significantly associated with disease progression. Patients with disc hemorrhage had a greater cumulative probability of progression than those without disc hemorrhage (P = .014 by log-rank test).
  
  
  CONCLUSIONS
  Our results support the importance of lowering IOP, even at the preperimetric stage. Preperimetric glaucoma patients with disc hemorrhage and insufficient IOP control should be carefully monitored for greater risk of progression.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Ko Eun
authors.initials: KE
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea. Electronic address: neuroprotect@gmail.com.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Jeoung
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Dong Myung
authors.initials: DM
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea; Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, South Korea.
authors.forename: Seong Joon
authors.initials: SJ
authors.lastname: Ahn
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea; Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Ki Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea; Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, South Korea.
authors.forename: Seok Hwan
authors.initials: SH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009898:Optic Disk / Q000503:physiopathology; D009901:Optic Nerve Diseases / Q000503:physiopathology; D012166:Retinal Hemorrhage / Q000503:physiopathology; D012307:Risk Factors; D014794:Visual Fields / Q000502:physiology