Gordon Mae O, Heuer Dale K, Higginbotham Eve J, Parrish Richard K, Liu Lei, Brandt James D, Huecker Julia B, Miller J Phillip, Perera Chamila, Xie Chris, Keltner John L, Johnson Chris A, Gardiner Stuart K, Liebmann Jeffrey M, Kass Michael A
From the Department of Ophthalmology and Visual Sciences, Washington University School of Medicine in St Louis (M.O.G., M.A.K.), St Louis, Missouri, USA.
Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin (D.K.H.), Milwaukee, Wisconsin, USA.
Am J Ophthalmol. 2025 Mar;271:360-370. doi: 10.1016/j.ajo.2024.11.017. Epub 2024 Dec 6.
To determine the rate of visual field (VF) loss before and after the diagnosis of primary open angle glaucoma (POAG) in the Ocular Hypertension Treatment Study (OHTS).
Prespecified analyses of data collected prospectively in a clinical trial with extended follow-up.
Participants who developed POAG during OHTS 1 and 2 (February 1994 to December 2008) constitute an inception cohort. Follow-up data were collected in OHTS 3 (January 2016-April 2019). Analyses were performed from July 2021 to August 2022.
In OHTS 1 and 2, visual field (VF) tests were performed every 6 months and stereoscopic optic disc photographs were taken every 12 months. These tests were repeated in OHTS 3.
Slopes of mean deviation (MD) were calculated by linear regression for all eyes in OHTS 1 and 2: eyes that did not develop POAG, eyes that developed optic disc POAG only, and eyes that developed VF POAG with/without optic disc POAG. Mean pre- and post-POAG slopes were calculated for eyes with a minimum of 5 VFs for each period.
Mean age at diagnosis of POAG was 66.4 ± 9.5 SD years (n = 282 participants), (56%) were male, 61% were White non-Hispanic and 32% were Black not Hispanic by self-report. The post-POAG slope was -0.40 ± 0.64 SD dB/year for all POAG eyes (n = 280 eyes), -0.19 ± 0.4 SD dB/yr. for optic disc POAG only eyes (n = 112 eyes), and -0.54 ± 0.7 SD dB/yr. for VF POAG eyes with or without optic disc POAG (n = 168 eyes). Among the VF POAG eyes, 69 (41%) had post-POAG MD slopes worse than or equal to -0.5 dB/year, 35 (21%) had slopes worse than or equal to -1.0 dB/year, and 9 (5.4%) had slopes worse than or equal to -2.0 dB/year.
Some participants in OHTS had rapid rates of VF loss in one or both eyes despite being followed in a clinical study. This emphasizes that ocular hypertensive patients require careful follow-up, especially those at high risk of developing POAG to ensure early diagnosis and appropriate treatment of POAG.
确定在高眼压治疗研究（OHTS）中，原发性开角型青光眼（POAG）诊断前后的视野（VF）损失率。
对前瞻性收集的数据进行预设分析，并进行延长随访的临床试验。
在OHTS 1和2期间（1994年2月至2008年12月）发生POAG的参与者构成一个起始队列。随访数据在OHTS 3中收集（2016年1月至2019年4月）。分析于2021年7月至2022年8月进行。
在OHTS 1和2中，每6个月进行一次视野（VF）测试，每12个月拍摄一次立体视盘照片。这些测试在OHTS 3中重复进行。
通过线性回归计算OHTS 1和2中所有眼睛的平均偏差（MD）斜率：未发生POAG的眼睛、仅发生视盘POAG的眼睛，以及发生VF POAG伴或不伴视盘POAG的眼睛。为每个时期至少有5次VF的眼睛计算POAG前后的平均斜率。
POAG诊断时的平均年龄为66.4±9.5标准差岁（n = 282名参与者），（56%）为男性，自我报告显示61%为非西班牙裔白人，32%为非西班牙裔黑人。所有POAG眼睛（n = 280只眼睛）的POAG后斜率为-0.40±0.64标准差dB/年，仅视盘POAG眼睛（n = 112只眼睛）为-0.19±0.4标准差dB/年，有或无视盘POAG的VF POAG眼睛（n = 168只眼睛）为-0.54±0.7标准差dB/年。在VF POAG眼睛中，69只（41%）的POAG后MD斜率比-0.5 dB/年差或等于-0.5 dB/年，35只（21%）的斜率比-1.0 dB/年差或等于-1.0 dB/年，9只（5.4%）的斜率比-2.0 dB/年差或等于-2.0 dB/年。
尽管在临床研究中进行了随访，但OHTS中的一些参与者一只或两只眼睛的VF损失率仍很快。这强调了高眼压患者需要仔细随访，尤其是那些有发生POAG高风险的患者，以确保POAG的早期诊断和适当治疗。
