title: Relationship between consecutive deterioration of mean deviation value and progression of visual field defect in open-angle glaucoma.
abstract: OBJECTIVE
  To analyze the relationship between consecutive deterioration of mean deviation (MD) value and glaucomatous visual field (VF) progression in open-angle glaucoma (OAG), including primary OAG and normal tension glaucoma.
  
  
  METHODS
  The subjects of the study were patients undergoing treatment for OAG who had performed VF tests at least 10 times with a Humphrey field analyzer (SITA standard, C30-2 program). The VF progression was defined by a significantly negative MD slope (MD slope worsening) at the final VF test during the follow-up period. The relationship between the MD slope worsening and the consecutive deterioration of MD value were retrospectively analyzed.
  
  
  RESULTS
  A total of 165 eyes of 165 patients were included in the analysis. Significant progression of VF defects was observed in 72 eyes of 72 patients (43.6%), while no significant progression was evident in 93 eyes of 93 patients (56.4%). There was significant relationship between the frequency of consecutive deterioration of MD value and MD slope worsening (P<0.0001, Cochran-Armitage trend test). A significant association was observed for MD slope worsening in the eyes with three (odds ratio: 2.1, P=0.0224) and four (odds ratio: 3.6, P=0.0008) consecutive deterioration of MD value in multiple logistic regression analysis, but no significant association in the eyes with two consecutive deterioration (odds ratio: 1.1, P=0.8282). The eyes with VF progression had significantly lower intraocular pressure reduction rate (P<0.01).
  
  
  CONCLUSIONS
  This retrospective study has shown that three or more consecutive deterioration of MD value might be a predictor to future significant MD slope worsening in OAG.
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Naito
authors.affiliation: Yoshikawa Eye Clinic, Tokyo, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Yoshikawa
authors.affiliation: Department of Ophthalmology, Ehime University Graduate School of Medicine, Ehime, Tokyo, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Mizoue
authors.affiliation: Kagurazaka Minamino Eye Clinic, Tokyo, Japan.
authors.forename: Mami
authors.initials: M
authors.lastname: Nanno
authors.affiliation: Ueno Eye Clinic, Tokyo, Japan.
authors.forename: Tairo
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Suzumura Eye Clinic, Tokyo, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Suzumura
authors.affiliation: Department of Agriculture, Kinki University, Nara, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Takeda
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
keywords: Humphrey field analyzer; consecutive deterioration; mean deviation slope; mean deviation value; normal tension glaucoma; primary open-angle glaucoma; visual field progression