Department of Ophthalmology, Aristotle University of Thessaloniki, School of Medicine, AHEPA Hospital, Thessaloniki, Greece.
Glaucoma Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
Br J Ophthalmol. 2018 Jul;102(7):916-921. doi: 10.1136/bjophthalmol-2017-310635. Epub 2017 Sep 28.
To provide population-based data on the maximum tolerable rate of progression to avoid visual impairment (maxTRoP_VI) and blindness (maxTRoP_BL) from open-angle glaucoma (OAG).
Participants with OAG in the Thessaloniki Eye Study (cross-sectional, population-based study in a European population) were included in the analysis. Visual impairment was defined as mean deviation (MD) equal to or worse than -12dB and blindness as MD equal to or worse than -24dB. Additional thresholds for visual impairment were tested. For each participant maxTRoP_VI was defined as the rate of progression which would not lead to visual impairment during expected lifetime. MaxTRoP_BL was defined accordingly. Both parameters were calculated for each OAG subject using age, sex, MD and life expectancy data. The eye with the better MD per subject was included in the analysis.
Among 135 subjects with OAG, 123 had reliable visual fields and were included in the analysis. The mean age was 73±6 years and the median MD was -3.65±5.28dB. Among those, 69.1% would have a maxTRoP_VI slower than -1dB/year and 18.7% would have a maxTRoP_VI between -1 and -2dB/year. Also, 72.4% would have a maxTRoP_BL slower than -2dB/year. For all tested thresholds for visual impairment, approximately 86% of the OAG study participants would not be able to tolerate a rate of progression equal to or faster than -2dB/year.
The majority of patients with glaucoma in our study would have a maximum tolerable rate of progression slower than -1dB/year in their better eye. Patient-tailored strategies to monitor the visual field are important, but raise the issue of feasibility with regard to the number of visual field tests needed.
提供基于人群的数据，以确定开角型青光眼（OAG）避免视力损害（maxTRoP_VI）和失明（maxTRoP_BL）的最大可耐受进展率。
纳入 Thessaloniki 眼研究（欧洲人群的横断面、基于人群的研究）中的 OAG 患者进行分析。视力损害定义为平均偏差（MD）等于或差于-12dB，失明定义为 MD 等于或差于-24dB。还测试了其他视力损害的阈值。对于每个参与者，maxTRoP_VI 定义为在预期寿命内不会导致视力损害的进展速度。相应地定义 maxTRoP_BL。使用每个 OAG 受试者的年龄、性别、MD 和预期寿命数据计算这两个参数。每个受试者中 MD 较好的眼睛被纳入分析。
在 135 名 OAG 患者中，123 名患者有可靠的视野，纳入分析。平均年龄为 73±6 岁，中位 MD 为-3.65±5.28dB。其中，69.1%的患者 maxTRoP_VI 较慢，低于-1dB/年，18.7%的患者 maxTRoP_VI 为-1 至-2dB/年。此外，72.4%的患者 maxTRoP_BL 较慢，低于-2dB/年。对于所有测试的视力损害阈值，大约 86%的 OAG 研究参与者无法耐受等于或快于-2dB/年的进展速度。
在我们的研究中，大多数青光眼患者在其较好的眼睛中最大可耐受进展速度较慢，低于-1dB/年。针对患者量身定制的监测视野策略很重要，但需要考虑到所需视野测试的数量，这引发了可行性问题。
