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Prognostic factors for progression of visual field damage in patients with normal-tension glaucoma.

Nakagami T, Yamazaki Y, Hayamizu F

Department of Ophthalmology, Nihon University School of Medicine, Tokyo, Japan. nakagami@med.nihon-u.ac.jp

PURPOSE: To evaluate the rate of progression and the prognostic factors of visual field damage in patients with normal-tension glaucoma (NTG). METHODS: Ninety-two NTG patients (92 eyes) were followed up for more than 2 years with topical antiglaucoma medications. All subjects were classified as having early damaged eyes with an initial mean deviation (MD) of -6 dB or better, moderately damaged eyes with MD between -6 dB and -12 dB, and severely damaged eyes with MD of -12 dB or worse, and survival data were analyzed using regression analysis based on the Cox proportional hazards model. RESULTS: The probability of visual field stability was significantly higher in patients with moderate damage than in those with severe damage (P = 0.035). The patients with early damage showed no difference in the probability of visual field stability compared with patients with moderate or severe damage. The progression of visual field damage was significantly associated with mean intraocular pressure (IOP) (P = 0.000) or IOP fluctuation (P = 0.002) during follow-up regardless of the severity of the initial visual field damage. CONCLUSIONS: The rate of progression of visual field damage differed according to the severity of the initial visual field damage. IOP reductive medication may be effective in preventing glaucomatous visual field progression in patients with NTG.

Published 2 February 2006 in Jpn J Ophthalmol, 50(1): 38-43.
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