Department of Ophthalmology, University Hospital, Lund University, Malmö, Sweden.
Eye (Lond). 2010 Oct;24 Suppl 1:S1-7. doi: 10.1038/eye.2010.112.
This review aims to provide guidance in managing glaucoma patients more effectively. It focuses on the importance of detecting progression and measuring its rate within the management of primary open-angle glaucoma today. Recent findings strongly indicate that continued monitoring of visual fields (VFs) and reassessment of target intraocular pressures (IOPs) depending on VF progression rates are mandatory in the management of glaucoma.
Data on glaucoma progression from older as well as most recent literature findings are summarized in this article. In addition, the article elaborates on the scientific content from a series of lectures given by experts in the field during several international symposia on 'rate of progression' in 2008.
This review summarizes key findings on the natural history of glaucoma and known factors for disease progression. It highlights the visual function changes observed as glaucoma progresses and discusses disease impact on patients' quality of life. Findings support the need to obtain information on rate of progression and its importance for clinical management. Practical ways to measure rate of progression are given by new software options to help measure major parameters. Finally, on the basis of a patient's individual rate of progression therapeutic options are assessed, such as maximum medical therapy with fixed combinations.
Estimating a patient's individual rate of VF progression by using newly developed analyses will be helpful to forecast the potential future development of the glaucoma. An individualized treatment approach then requires that in patients in whom the risk of becoming visually impaired or blind during their lifetime is higher, a more intensive medical IOP-lowering therapy such as fixed combinations can be considered as treatment option.
本文旨在提供更有效地管理青光眼患者的指导。它侧重于在当今原发性开角型青光眼的管理中检测进展并测量其进展率的重要性。最近的研究结果强烈表明，在青光眼的管理中，必须继续监测视野（VF）并根据 VF 进展率重新评估目标眼内压（IOP）。
本文总结了旧文献和最近文献中有关青光眼进展的数据。此外，本文还详细阐述了在 2008 年几次关于“进展率”的国际研讨会上，该领域专家的一系列演讲中的科学内容。
本文总结了青光眼自然史和已知疾病进展因素的关键发现。它强调了随着青光眼的进展而观察到的视觉功能变化，并讨论了疾病对患者生活质量的影响。研究结果支持获取进展率信息及其对临床管理的重要性的必要性。新的软件选项提供了测量进展率的实用方法，以帮助测量主要参数。最后，根据患者个体的 VF 进展率，评估治疗选择，例如使用固定组合的最大药物治疗。
通过使用新开发的分析方法估计患者的个体 VF 进展率，将有助于预测青光眼的潜在未来发展。然后，个体化治疗方法要求在那些一生中视力受损或失明风险更高的患者中，可以考虑更强化的药物降低 IOP 治疗，如固定组合作为治疗选择。
