University Eye Clinic Maastricht, Maastricht, The Netherlands; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands.
University Eye Clinic Maastricht, Maastricht, The Netherlands.
Ophthalmology. 2013 Mar;120(3):512-519. doi: 10.1016/j.ophtha.2012.09.005. Epub 2012 Dec 1.
To examine which prognostic factors are associated with glaucomatous visual field progression.
Knowledge of prognostic factors helps clinicians to select patients at risk of glaucomatous visual field progression and intensify their treatment.
By consulting relevant databases, we identified 2733 articles published up to September 2010, of which 85 articles investigating prognostic factors for visual field progression in patients with open-angle glaucoma (OAG) were eligible. We summarized results for each factor in tables, noting the direction of the association between the prognostic factor and progression, and the accompanying P value. Four authors, working blind to the factors, independently judged the extent to which a prognostic factor was associated with glaucomatous visual field progression. If there were different associations for normal-tension glaucoma (NTG) studies, they were judged separately. Consensus was reached during group meetings.
A ranking of all studied prognostic factors for glaucomatous visual field progression according to their likelihood of being prognostic.
A total of 103 different prognostic factors were investigated in 85 articles. The following factors were clearly associated with glaucomatous visual field progression: age, disc hemorrhages (for NTG), baseline visual field loss, baseline intraocular pressure (IOP), and exfoliation syndrome. An association was unlikely for family history of glaucoma, atherosclerosis, systemic hypertension, visual acuity, sex (for NTG), systolic blood pressure, myopic refractive error (for NTG), and Raynaud's phenomenon.
The factors we found clearly associated with progression could be used in clinical practice and for developing clinical prediction models. For many other factors, further research is necessary.
探讨哪些预后因素与青光眼视野进展相关。
了解预后因素有助于临床医生选择有青光眼视野进展风险的患者，并加强治疗。
通过查阅相关数据库，我们共检索到截至 2010 年 9 月发表的 2733 篇文献，其中 85 篇文章调查了开角型青光眼（OAG）患者视野进展的预后因素。我们将每个因素的结果总结在表中，指出预后因素与进展之间的关联方向及相应的 P 值。四位作者在不了解因素的情况下，独立判断预后因素与青光眼视野进展的关联程度。如果正常眼压性青光眼（NTG）研究的关联不同，则分别判断。在小组会议期间达成共识。
根据与青光眼视野进展相关的可能性，对所有研究的预后因素进行排名。
在 85 篇文章中，共调查了 103 种不同的预后因素。以下因素与青光眼视野进展明显相关：年龄、视盘出血（NTG）、基线视野损失、基线眼内压（IOP）和剥脱综合征。家族性青光眼病史、动脉粥样硬化、系统性高血压、视力、性别（NTG）、收缩压、近视屈光不正（NTG）和雷诺现象与青光眼视野进展的相关性不大。
我们发现与进展明显相关的因素可用于临床实践和开发临床预测模型。对于许多其他因素，还需要进一步研究。
