Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Australia.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Invest Ophthalmol Vis Sci. 2019 Jan 2;60(1):161-167. doi: 10.1167/iovs.18-25391.
To compare the distribution of visual field progression rates in three subgroups of glaucoma, being primary angle-closure glaucoma (PACG), POAG, and juvenile open-angle glaucoma (JOAG).
We assessed glaucoma patients treated in an Indian tertiary care setting with at least four visual field assessments. We determined rates from a single eye of each of 525 patients using linear regression of the summary index mean deviation (MD) over time. The main outcome measures were the proportions of fast (<-1.0 to -2.0 dB/y) and catastrophic (<-2 dB/y) visual field progression. Bootstrapped 95% CIs allowed comparison with published data from a large clinical cohort in Canada.
The combined proportion of fast and catastrophic progressors in our cohort was less than half that in the Canada dataset (2.3% vs. 5.8%), despite median progression rates differing by only 0.03 dB/y. PACG, POAG, and JOAG represented 45%, 32%, and 12% of our cohort, respectively. Baseline MD values were similarly distributed between these subtypes. All subtypes showed a similar shaped distribution for progression rates, with median progression rates of -0.03, -0.05, and 0.02 dB/y for PACG, POAG, and JOAG, respectively. Combined proportions of fast and catastrophic progression rates did not significantly differ between subtypes.
Differences in fast and catastrophic visual field progression can exist despite only small changes in median progression rates, highlighting the importance of considering the full shape of the progression rate distribution when comparing the risk of devastating visual field loss.
比较三种青光眼（原发性闭角型青光眼、POAG 和青少年开角型青光眼）亚组中视野进展率的分布。
我们评估了在印度一家三级护理机构接受治疗的青光眼患者，这些患者至少接受了四次视野评估。我们使用时间汇总指数平均偏差（MD）的线性回归，从 525 名患者的每只单眼确定了速率。主要观察指标是快速（<-1.0 至-2.0 dB/y）和灾难性（<-2 dB/y）视野进展的比例。通过 bootstrap 95%CI 允许与加拿大大型临床队列中的已发表数据进行比较。
尽管进展率仅相差 0.03 dB/y，但我们队列中的快速和灾难性进展者的综合比例低于加拿大数据集（2.3%比 5.8%）。PACG、POAG 和 JOAG 分别占我们队列的 45%、32%和 12%。这些亚型之间的基线 MD 值分布相似。所有亚型的进展率分布形状相似，PACG、POAG 和 JOAG 的中位进展率分别为-0.03、-0.05 和 0.02 dB/y。快速和灾难性进展率的综合比例在亚型之间没有显著差异。
尽管中位进展率仅略有变化，但快速和灾难性视野进展之间可能存在差异，这凸显了在比较灾难性视野丧失风险时考虑进展率分布的整体形状的重要性。
