TY - JOUR
T1 - Risk factors for progression of visual field abnormalities in normal-tension glaucoma
AU - Drange, Stephen
AU - Anderson, Douglas R.
AU - Schulzer, Michael
N1 - Funding Information:
This study was supported by the Glaucoma Research Foundation, San Francisco, California, with special grants from the Oxnard Foundation and the Edward J. Daly Foundation, San Francisco, California.
PY - 2001
Y1 - 2001
N2 - • PURPOSE: To uncover risk factors for the highly variable individual rates of progression in cases of untreated normal-tension glaucoma. • METHODS: Visual field data were assembled from 160 subjects (160 eyes) enrolled in the collaborative normal-tension glaucoma study during intervals in which the eye under study was not receiving intraocular pressure-lowering treatment during prerandomization and postrandomization intervals. Analyses included multivariate analysis of time-dependent Cox proportional hazard, Kaplan-Meier analysis of "survival" without an increment of visual field worsening, and comparison of slopes of change in mean deviation global index over time. • RESULTS: Most migraine occurred in women, but analysis demonstrated that gender and presence of migraine contribute separately to the overall risk. The risk ratio for migraine, adjusted for the other variables was 2.58 (P = .0058), for disk hemorrhage was 2.72 (P = .0036), and for female gender 1.85 (P = .0622). The average fall in the mean deviation index was faster in nonmigrainous women than in nonmigrainous men (P = .05). Suggesting genetic influence, Asians had a slower rate of progression (P = .005), and the few black patients enrolled had a tendency for faster progression. However, self-declared history of family with glaucoma or treated for glaucoma did not affect the rate of progression. Neither age nor the untreated level of intraocular pressure affected the rate of untreated disease progression, despite their known influence on prevalence. • CONCLUSIONS: Whereas risk factors for prevalence help select populations within which to screen for glaucoma, the factors that affect the rate of progression help decide the expected prognosis of the individual's untreated disease and thereby the frequency of follow-up and aggressiveness of the therapy to be undertaken.
AB - • PURPOSE: To uncover risk factors for the highly variable individual rates of progression in cases of untreated normal-tension glaucoma. • METHODS: Visual field data were assembled from 160 subjects (160 eyes) enrolled in the collaborative normal-tension glaucoma study during intervals in which the eye under study was not receiving intraocular pressure-lowering treatment during prerandomization and postrandomization intervals. Analyses included multivariate analysis of time-dependent Cox proportional hazard, Kaplan-Meier analysis of "survival" without an increment of visual field worsening, and comparison of slopes of change in mean deviation global index over time. • RESULTS: Most migraine occurred in women, but analysis demonstrated that gender and presence of migraine contribute separately to the overall risk. The risk ratio for migraine, adjusted for the other variables was 2.58 (P = .0058), for disk hemorrhage was 2.72 (P = .0036), and for female gender 1.85 (P = .0622). The average fall in the mean deviation index was faster in nonmigrainous women than in nonmigrainous men (P = .05). Suggesting genetic influence, Asians had a slower rate of progression (P = .005), and the few black patients enrolled had a tendency for faster progression. However, self-declared history of family with glaucoma or treated for glaucoma did not affect the rate of progression. Neither age nor the untreated level of intraocular pressure affected the rate of untreated disease progression, despite their known influence on prevalence. • CONCLUSIONS: Whereas risk factors for prevalence help select populations within which to screen for glaucoma, the factors that affect the rate of progression help decide the expected prognosis of the individual's untreated disease and thereby the frequency of follow-up and aggressiveness of the therapy to be undertaken.
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U2 - 10.1016/S0002-9394(01)00964-3
DO - 10.1016/S0002-9394(01)00964-3
M3 - Article
C2 - 11384564
AN - SCOPUS:0035004896
VL - 131
SP - 699
EP - 708
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
IS - 6
ER -