title: Blindness and Glaucoma: A Multicenter Data Review from 7 Academic Eye Clinics.
abstract: OBJECTIVE
  To evaluate frequency, conversion rate, and risk factors for blindness in glaucoma patients treated in European Universities.
  
  
  METHODS
  This multicenter retrospective study included 2402 consecutive patients with glaucoma in at least one eye. Medical charts were inspected and patients were divided into those blind and the remainder ('controls'). Blindness was defined as visual acuity≤0.05 and/or visual field loss to less than 10°.
  
  
  RESULTS
  Unilateral and bilateral blindness were respectively 11.0% and 1.6% at the beginning, and 15.5% and 3.6% at the end of the observation period (7.5±5.5 years, range:1-25 years); conversion to blindness (at least unilateral) was 1.1%/year. 134 eyes (97 patients) developed blindness by POAG during the study. At the first access to study centre, they had mean deviation (MD) of -17.1±8.3 dB and treated intraocular pressure (IOP) of 17.1±6.6 mmHg. During follow-up the IOP decreased by 14% in these eyes but MD deteriorated by 1.1±3.5 dB/year, which was 5-fold higher than controls (0.2±1.6 dB/year). In a multivariate model, the best predictors for blindness by glaucoma were initial MD (p<0.001), initial IOP (p<0.001), older age at the beginning of follow-up (p<0.001), whereas final IOP was found to be protective (p<0.05).
  
  
  CONCLUSIONS
  In this series of patients, blindness occurred in about 20%. Blindness by glaucoma had 2 characteristics: late diagnosis and/or late referral, and progression of the disease despite in most cases IOP was within the range of normality and target IOP was achieved; it could be predicted by high initial MD, high initial IOP, and old age.
authors: Dipartimento Testa-Collo, San Paolo Hospital, University of Milan, Milan, Italy.
authors: Luca
authors: L
authors: Rossetti
authors: Dipartimento Testa-Collo, San Paolo Hospital, University of Milan, Milan, Italy.
authors: Maurizio
authors: M
authors: Digiuni
authors: Giovanni
authors: G
authors: Montesano
authors: Dipartimento Testa-Collo, San Paolo Hospital, University of Milan, Milan, Italy.
authors: Montesano
authors: M
authors: Giovanni
authors: G. B. Bietti Foundation-IRCCS, Rome, Italy.
authors: Marco
authors: M
authors: Centofanti
authors: Università degli Studi di Torino, Turin, Italy.
authors: Antonio M
authors: AM
authors: Fea
authors: Clinica Oculistica, Università di Genova, Genoa, Italy.
authors: Michele
authors: M
authors: Iester
authors: Dipartimento di Scienze oftalmologiche e Neurochirurgiche, Universita' degli Studi di Siena, Siena, Italy.
authors: Paolo
authors: P
authors: Frezzotti
authors: Eye Clinic, Department of Neuroscience, University of Pisa, Pisa, Italy.
authors: Michele
authors: M
authors: Figus
authors: Department of Ophthalmology, Miguel Servet University Hospital, University of Zaragoza, Zaragoza, Spain.
authors: Antonio
authors: A
authors: Ferreras
authors: G. B. Bietti Foundation-IRCCS, Rome, Italy.
authors: Francesco
authors: F
authors: Oddone
authors: G. B. Bietti Foundation-IRCCS, Rome, Italy.
authors: Lucia
authors: L
authors: Tanga
authors: Università degli Studi di Torino, Turin, Italy.
authors: Teresa
authors: T
authors: Rolle
authors: Università degli Studi di Torino, Turin, Italy.
authors: Valentina
authors: V
authors: Battaglino
authors: Eye Clinic, Department of Neuroscience, University of Pisa, Pisa, Italy.
authors: Chiara
authors: C
authors: Posarelli
authors: Dipartimento di Scienze oftalmologiche e Neurochirurgiche, Universita' degli Studi di Siena, Siena, Italy.
authors: Ilaria
authors: I
authors: Motolese
authors: Dipartimento di Scienze oftalmologiche e Neurochirurgiche, Universita' degli Studi di Siena, Siena, Italy.
authors: Pietro
authors: P
authors: Mittica
authors: Dipartimento di Scienze oftalmologiche e Neurochirurgiche, Universita' degli Studi di Siena, Siena, Italy.
authors: Simone Alex
authors: SA
authors: Bagaglia
authors: Dipartimento di Scienze oftalmologiche e Neurochirurgiche, Universita' degli Studi di Siena, Siena, Italy.
authors: Cristina
authors: C
authors: Menicacci
authors: Dipartimento Testa-Collo, San Paolo Hospital, University of Milan, Milan, Italy; Unit of Ophthalmology, Ospedale Maggiore della Carità, Novara, Italy.
authors: Stefano
authors: S
authors: De Cilla'
authors: Dipartimento Testa-Collo, San Paolo Hospital, University of Milan, Milan, Italy.
authors: Alessandro
authors: A
authors: Autelitano
authors: Dipartimento Testa-Collo, San Paolo Hospital, University of Milan, Milan, Italy.
authors: Paolo
authors: P
authors: Fogagnolo
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005901:Glaucoma / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology*; D019987:Persons with Visual Disabilities