Sullivan-Mee Michael, Kimura Bryan, Kee Helen, Hedayat Mahdi, Charry Nicole, Katiyar Suchitra, Pensyl Denise, Qualls Clifford
Eye Clinic Raymond G. Murphy VA Medical Center.
Eye Associates of New Mexico.
J Glaucoma. 2023 Jan 1;32(1):1-8. doi: 10.1097/IJG.0000000000002138. Epub 2022 Oct 12.
Presence of baseline 10-2 visual field (VF) loss was the strongest predictor of future rate of 24-2 VF loss and development of new 24-2 progression events, suggesting a role for 10-2 VF testing in baseline glaucoma risk analysis.
The purpose of this study is to examine the relationship between baseline 10-2 VF loss and future 24-2 VF loss.
Subjects were participating in a prospective longitudinal study within a VA Medical Center outpatient eye clinic. Eligibility required 2 good quality baseline 10-2 VF tests followed by a minimum of 5 good quality 24-2 VF tests over at least 3 years. Longitudinal 24-2 VF testing was completed every 4-6 months after baseline 10-2 testing. Mixed model regression analyses and Cox Proportional Hazard regression analyses were completed to identify predictors of 24-2 mean deviation change rate and new VF loss events.
We studied 394 eyes of 202 subjects (119 primary open angle glaucoma and 83 glaucoma suspect). Over 6.7 (±1.5) years, 9.9 (±2.3) good quality 24-2 VF tests were completed. In mixed model regression analyses, baseline variables that predicted faster rate of 24-2 VF loss in order of strength of association were presence of baseline 10-2 VF defect, lower 24-2 mean deviation, and higher age. When analyses were completed without 10-2 variables, predictive capability of the model was reduced compared with when 10-2 variables were included. In Cox Proportional Regression analyses evaluating progression events, baseline 10-2 VF defect demonstrated the largest hazard ratio (22 times greater risk for developing future VF loss event in eyes with vs. without baseline 10-2 VF loss).
Baseline 10-2 VF defect was the most effective predictor of subsequent 24-2 VF progression in this study. These findings imply that presence of baseline 10-2 VF loss may provide unique value for predicting future glaucoma progression.
基线10-2视野（VF）缺损是未来24-2视野缺损率及新的24-2进展事件发生的最强预测因素，提示10-2视野检测在基线青光眼风险分析中具有一定作用。
本研究旨在探讨基线10-2视野缺损与未来24-2视野缺损之间的关系。
研究对象为参与一家退伍军人医疗中心门诊眼科前瞻性纵向研究的患者。入选标准要求有2次质量良好的基线10-2视野检测结果，且在至少3年时间内至少有5次质量良好的24-2视野检测结果。在基线10-2检测后，每4-6个月进行一次纵向24-2视野检测。完成混合模型回归分析和Cox比例风险回归分析，以确定24-2平均偏差变化率和新视野缺损事件的预测因素。
我们研究了202名受试者的394只眼睛（119例原发性开角型青光眼和83例青光眼可疑患者）。在6.7（±1.5）年的时间里，共完成了9.9（±2.3）次质量良好的24-2视野检测。在混合模型回归分析中，按关联强度顺序预测24-2视野缺损率更快的基线变量依次为基线10-2视野缺损的存在、较低的24-2平均偏差和较高的年龄。当分析不包括10-2变量时，与纳入10-2变量时相比，模型的预测能力降低。在评估进展事件的Cox比例回归分析中，基线10-2视野缺损显示出最大的风险比（有基线10-2视野缺损的眼睛发生未来视野缺损事件的风险是无基线10-2视野缺损眼睛的22倍）。
在本研究中，基线10-2视野缺损是后续24-2视野进展最有效的预测因素。这些发现表明，基线10-2视野缺损的存在可能为预测未来青光眼进展提供独特价值。
