title: Are rates of vision loss in patients in English glaucoma clinics slowing down over time? Trends from a decade of data.
abstract: OBJECTIVE
  To examine changes in rates of visual field (VF) progression in patients attending a sample of glaucoma clinics in England between 1999 and 2012.
  
  
  METHODS
  An archive of 473 252 Humphrey VFs recorded across the UK was retrospectively examined. Distribution of rates recorded in the first half of the decade was compared with the second. The relationship between age and severity of MD loss at baseline with rates of loss and frequency of testing was examined.
  
  
  RESULTS
  VF series from 18 926 eyes were analysed. Median rate of MD loss for the period before and after 2003 was -0.11 and -0.06 dB/year, respectively, but the proportion of eyes with medium or fast rates of MD loss remained constant. Median rate of MD loss in older (>70 years) eyes was faster than that observed in younger (<60 years) eyes (-0.21 compared with -0.01 dB/year). Median rate of loss did not vary with severity of MD loss at baseline. Frequency of testing, typically carried out annually, did not vary by age, rate of loss or disease severity.
  
  
  CONCLUSIONS
  VFs of eyes treated in the first half of the decade deteriorated more rapidly than those in the second half. Several factors might explain these differences but average effects were small and there was no reduction in the proportion of rapidly progressing eyes over the decade. Older age and, to a lesser extent, worse VF damage at diagnosis are indicators for faster VF loss in clinics, but frequency of VF testing was similar for all patients.
authors: Optometry and Visual Science, School of Health Sciences, City University London, London, UK.
authors: T
authors: T
authors: Boodhna
authors: Optometry and Visual Science, School of Health Sciences, City University London, London, UK.
authors: L J
authors: LJ
authors: Saunders
authors: Optometry and Visual Science, School of Health Sciences, City University London, London, UK.
authors: D P
authors: DP
authors: Crabb
mesh_terms: D000368:Aged; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009901:Optic Nerve Diseases / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology*; D058609:Visual Field Tests; D014794:Visual Fields