Shen Ruyue, Chan Poemen P, Ling Anni, Chan Noel C Y, Wong Mandy Oi-Man, Lai Isabel, Cheung Carol Y, Tham Clement C
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Ophthalmology and Visual Sciences, Lam Kin Chung, Jet King-Shing Ho Glaucoma Treatment and Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China.
Invest Ophthalmol Vis Sci. 2025 Jul 1;66(9):59. doi: 10.1167/iovs.66.9.59.
To identify associated long-term risk factors of visual field (VF) progression among eyes of primary angle-closure disease (PACD), including primary angle-closure suspect (PACS), primary angle-closure (PAC), and primary angle-closure glaucoma (PACG).
PACD eyes with at least a 10-year follow-up duration were included. VF was tested every 6 months using the 24-2 pattern standard on the Humphrey Field Analyzer. The initial intraocular pressure (IOP) fluctuation and initial visual field index (VFI) slope were calculated based on the first-year follow-up data. Univariable and multivariable Cox proportional hazards regression models were calculated to determine potential risk factors associated with VF progression, as assessed by guided progression analysis.
Forty out of 129 eyes with PACD (31.0%) developed VF progression, including two out of 11 PACS eyes (18.2%), nine out of 52 PAC eyes (17.3%), and 29 out of 66 PACG eyes (43.9%). In multivariable Cox models, among PACG eyes, higher IOP fluctuation (hazard ratio [HR] = 1.591; 95% confidence interval [CI], 1.128-2.245) and steeper initial VFI slope (HR = 3.325; 95% CI, 2.046-5.404) were associated with VF progression. Among PACS/PAC eyes, a steeper initial VFI slope (HR = 4.848; 95% CI, 1.627-14.448) was associated with VF progression (P ≤ 0.008).
Our findings underscore the importance of monitoring IOP fluctuation in PACG eyes and initial VFI slope in PACD eyes, supporting the implementation of tailored management strategies based on disease severity and refractive status.
确定原发性闭角型疾病（PACD）患者眼睛视野（VF）进展的相关长期危险因素，包括原发性闭角型可疑（PACS）、原发性闭角型（PAC）和原发性闭角型青光眼（PACG）。
纳入随访时间至少为10年的PACD患者眼睛。使用Humphrey视野分析仪上的24-2模式标准每6个月测试一次视野。根据第一年的随访数据计算初始眼压（IOP）波动和初始视野指数（VFI）斜率。计算单变量和多变量Cox比例风险回归模型，以确定与VF进展相关的潜在危险因素，通过引导进展分析进行评估。
129只PACD眼睛中有40只（31.0%）出现VF进展，其中11只PACS眼睛中有2只（18.2%），52只PAC眼睛中有9只（17.3%），66只PACG眼睛中有29只（43.9%）。在多变量Cox模型中，在PACG眼睛中，较高的IOP波动（风险比[HR]=1.591；95%置信区间[CI]，1.128-2.245）和较陡的初始VFI斜率（HR=3.325；95%CI，2.046-5.404）与VF进展相关。在PACS/PAC眼睛中，较陡的初始VFI斜率（HR=4.848；95%CI，1.627-14.448）与VF进展相关（P≤0.008）。
我们的研究结果强调了监测PACG眼睛中IOP波动以及PACD眼睛中初始VFI斜率的重要性，支持根据疾病严重程度和屈光状态实施定制化管理策略。
