Patil Trupti S, Natarajan Viswanathan, George Ronnie
Smt. Jadhavbai Nathamal Singhvi Glaucoma Services, Sankara Nethralaya Medical Research Foundation, Chennai, Tamil Nadu, India.
Indian J Ophthalmol. 2024 Dec 1;72(12):1734-1740. doi: 10.4103/IJO.IJO_2735_23. Epub 2024 Aug 14.
To identify the risk factors for central visual field progression in moderate to advanced glaucoma.
We included patients with moderate to advanced primary glaucoma who had undergone at least five reliable Humphrey visual field (HVF) 10-2 tests with follow-up of at least 2 years. Regression slopes for each threshold location on the 10-2 plot were calculated. A test location with a regression slope worsening more than -1 dB/year with P < 0.01 was labeled as a progressing point on point-wise linear regression (PLR) analysis. We compared point-wise progression with progression on the 10-2 mean deviation (defined as a negative MD slope P < 0.05).
Ninety-six eyes of 74 patients with a median follow-up of 4 years (±1.97) were included. The median mean deviation 10-2 (MD) at inclusion was -19.01 dB (interquartile range [IQR] -13.2 to -24.14). Eighteen eyes (18.75%) had moderate glaucoma and 78 eyes (81.25%) had advanced glaucoma. The baseline median 24-2 MD in moderate glaucoma was -10.35 dB (IQR -11.35 to -9.25) and in advanced glaucoma was -24.96 dB (IQR -28.48 to -18.26). Based on 10-2 PLR, 27 eyes (28%) showed progression. On multivariate logistics regression analysis, the rate of change for 10-2 MD was a risk factor for progression based on 10-2 PLR analysis: odds ratio (OR) 0.04 (95% confidence interval [CI]: 0.006-0.323), P = 0.002, and for progression based on 10-2 MD analysis: OR 0.03 (95% CI: 0.002-0.602), P = 0.02. In addition, average MD 24-2 (OR 1.343 [95% CI: 1.006-1.793], P = 0.04) and visual field index (OR 0.787 [95% CI: 0.649-0.954], P = 0.01) were found to be risk factors based on 10-2 PLR.
Rate of change for 10-2 mean deviation and baseline damage were predictors of point-wise progression.
确定中度至重度青光眼患者中心视野进展的危险因素。
我们纳入了中度至重度原发性青光眼患者，这些患者至少接受了5次可靠的汉弗莱视野（HVF）10-2检测，且随访时间至少为2年。计算10-2视野图上每个阈值位置的回归斜率。在逐点线性回归（PLR）分析中，回归斜率恶化超过-1 dB/年且P<0.01的检测位置被标记为进展点。我们将逐点进展与10-2平均偏差的进展情况进行比较（定义为负的平均偏差斜率P<0.05）。
纳入了74例患者的96只眼，中位随访时间为4年（±1.97）。纳入时的中位10-2平均偏差（MD）为-19.01 dB（四分位间距[IQR]-13.2至-24.14）。18只眼（18.75%）为中度青光眼，78只眼（81.25%）为重度青光眼。中度青光眼患者基线24-2平均偏差的中位数为-10.35 dB（IQR-11.35至-9.25），重度青光眼患者为-24.96 dB（IQR-28.48至-18.26）。基于10-2 PLR分析，27只眼（28%）出现进展。在多因素逻辑回归分析中，基于10-2 PLR分析，10-2平均偏差的变化率是进展的危险因素：比值比（OR）0.04（95%置信区间[CI]：0.006-0.323），P=0.002；基于10-2平均偏差分析，进展的OR为0.03（95%CI：0.002-0.602），P=0.02。此外，基于10-2 PLR分析，24-2平均偏差平均值（OR 1.343[95%CI：1.006-1.793]，P=0.04）和视野指数（OR 0.787[95%CI：0.649-0.954]，P=0.01）被发现是危险因素。
10-2平均偏差的变化率和基线损伤是逐点进展的预测因素。
