title: Persistence of Glaucoma Therapy and Visual Field Progression.
abstract: OBJECTIVE
  To determine the association of visual field (VF) progression with medication persistence in a cohort on glaucoma therapy.
  
  
  METHODS
  Pharmacy records were examined over 3 years for patients started on glaucoma monotherapy. A patient was persistent if a prescription was refilled for the same medication < 90 days after the previous prescription had lapsed; otherwise was nonpersistent. Only patients with > 5 reliable VFs within 1-year pretherapy and 6-year posttherapy were included. Progression was analyzed with pointwise linear regression and defined using 2 criteria: (A) ≥ 2 adjacent progressing points (slope P < 0.01) in 1 hemifield; and (B) ≥ 3 progressing points (slope P < 0.01). The mean number and mean slope of progressing points and the mean global slopes were determined.
  
  
  RESULTS
  Of 1206 patient eyes (131 persistent, 1075 nonpersistent), 941 were excluded leaving 175 (47 persistent and 128 nonpersistent) for analysis. The mean follow-up durations were 59.3 ± 10.9 and 58.2 ± 9.7 months (P = 0.07) for persistent and nonpersistent eyes, respectively. Overall, 2/47 (4.3%) and 10/128 (7.8%) eyes progressed among persistent and nonpersistent patients, respectively (P = 0.52) using criterion A and 1/47 (2.1%) and 12/128 (9.4%; P = 0.19) eyes using criterion B. Mean number of progressing points (0.3 ± 0.9 vs. 0.7 ± 1.8; P = 0.17), mean slope of progressing points (-2.2 ± 1.1 vs. -2.8 ± 1.3 dB/y; P = 0.27), and mean global slope (0.7 ± 0.5 vs. -0.1 ± 0.8 dB/y; P = 0.07) were similar for persistent and nonpersistent patients, respectively.
  
  
  CONCLUSIONS
  There were small but appreciable differences in VF progression rates between persistent and nonpersistent patient eyes on glaucoma drops, but differences were not significant.
authors.affiliation: *Singapore and Singapore National Eye Centre, Singapore Eye Research Institute ‡Duke-NUS Medical School §Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore †Cardinal Santos Medical Center, San Juan City, Metro Manila, Philippines.
authors.forename: John M S
authors.initials: JM
authors.lastname: de Leon
authors.forename: Desmond T
authors.initials: DT
authors.lastname: Quek
authors.forename: Hla M
authors.initials: HM
authors.lastname: Htoon
authors.forename: Tin A
authors.initials: TA
authors.lastname: Tun
authors.forename: Shamira A
authors.initials: SA
authors.lastname: Perera
authors.forename: Ecosse L
authors.initials: EL
authors.lastname: Lamoureux
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014786:Vision Disorders / Q000175:diagnosis* / Q000503:physiopathology; D058609:Visual Field Tests; D014794:Visual Fields
chemical_list: D000959:Antihypertensive Agents