title: Relationship between visual field progression and baseline refraction in primary open-angle glaucoma.
abstract: OBJECTIVE
  To analyze the relationship between visual field (VF) progression and baseline refraction in Japanese patients with primary open-angle glaucoma (POAG) including normal-tension glaucoma.
  
  
  METHODS
  In this retrospective study, the subjects were patients with POAG who had undergone VF tests at least ten times with a Humphrey Field Analyzer (Swedish interactive thresholding algorithm standard, Central 30-2 program). VF progression was defined as a significantly negative value of mean deviation (MD) slope at the final VF test. Multivariate logistic regression models were applied to detect an association between MD slope deterioration and baseline refraction.
  
  
  RESULTS
  A total of 156 eyes of 156 patients were included in this analysis. Significant deterioration of MD slope was observed in 70 eyes of 70 patients (44.9%), whereas no significant deterioration was evident in 86 eyes of 86 patients (55.1%). The eyes with VF progression had significantly higher baseline refraction compared to those without apparent VF progression (-1.9±3.8 diopter [D] vs -3.5±3.4 D, P=0.0048) (mean ± standard deviation). When subject eyes were classified into four groups by the level of baseline refraction applying spherical equivalent (SE): no myopia (SE > -1D), mild myopia (-1D ≥ SE > -3D), moderate myopia (-3D ≥ SE > -6D), and severe myopia (-6D ≥ SE), the Cochran-Armitage trend analysis showed a decreasing trend in the proportion of MD slope deterioration with increasing severity of myopia (P=0.0002). The multivariate analysis revealed that baseline refraction (P=0.0108, odds ratio [OR]: 1.13, 95% confidence interval [CI]: 1.03-1.25) and intraocular pressure reduction rate (P=0.0150, OR: 0.97, 95% CI: 0.94-0.99) had a significant association with MD slope deterioration.
  
  
  CONCLUSIONS
  In the current analysis of Japanese patients with POAG, baseline refraction was a factor significantly associated with MD slope deterioration as well as intraocular pressure reduction rate. When baseline refraction was classified into four groups, MD slope in myopia groups was less deteriorated as compared to those in the emmetropic/hyperopic group.
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, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Mizoue
authors.affiliation: Kagurazaka Minamino Eye Clinic.
authors.forename: Mami
authors.initials: M
authors.lastname: Nanno
authors.affiliation: Ueno Eye Clinic.
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 Gastroenterological Surgery, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Umeda
authors.affiliation: Department of Ophthalmology, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Shiraga
keywords: MD slope; intraocular pressure reduction rate; myopia; normal-tension glaucoma; primary open-angle glaucoma; refraction; visual field progression