Neuroretinal Rim Area Change in Glaucoma Patients With Visual Field Progression Endpoints and Intraocular Pressure Reduction. The Canadian Glaucoma Study: 4

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• 作者：Rizwan Malik^aAuthor Vitae ; Neil O'Leary^a ; Frederick S. Mikelberg^b ; A. Gordon Balazsi^c ; Raymond P. LeBlanc^a ; Mark R. Lesk^d ; Marcelo T. Nicolela^a ; Graham E. Trope^e ; Balwantray C. Chauhan^a ; ^{bal@dal.ca" class="auth_mail" title="E-mail the corresponding author} ; on behalf of the Canadian Glaucoma Study GroupPaul H. Artes ; PhD ; Marcelo T. Nicolela ; MD ; Raymond P. LeBlanc ; CM ; MD ; Paul E. Rafuse ; MD ; PhD ; David M. Andrews ; MD ; Mohammad Humayun ; MD ; James MacNeill ; MD ; Andrew C. Orr ; MD ; John H. Quigley ; MD ; George A. Sapp ; MD ; Christine A. MacDonald ; BSc ; Helen M. Sauveur ; BSc ; Sara L. Lavender ; MSc ; A. Gordon Balazsi ; MD ; Oscar P. Kasner ; MD ; Nabil E. Saheb ; MD ; Alan J. Coffey ; MD ; W. Edward Connolly ; MD ; Marino J. Discepola ; MD ; Conrad C. Kavalec ; MD ; Susan K. Lindley ; MD ; Marc Mullie ; MD ; Pearl Alexander ; BSc ; Bonnie May ; BSc ; Gordon R. Douglas ; MD ; Stephen M. Drance ; OC ; MD ; Frederick S. Mikelberg ; MD ; Jeffrey A. Blicker ; MD ; Robin S. Cottle ; MD ; Vincent Wong ; MD ; Zarina Pardhan ; BSc ; Mark R. Lesk ; MSc ; MD ; Yvonne M. Buys ; MD ; John G. Flanagan ; PhD ; Graham E. Trope ; MB ; PhD ; Catherine M. Birt ; MD ; Michael W. Easterbrook ; MD ; William G. Macrae ; MD ; Samuel N. Markowitz ; MD ; Maureen Wolpert ; MD ; Emad Eskander ; MD ; Christine A. Macgillivray ; BSc ; Erin Hicks ; Kathryn Patterson ; Andrew Vassallo ; Pantelis Andreou ; PhD
• 刊名：American Journal of Ophthalmology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：163
• 期：Complete
• 页码：140-147.e1
• 全文大小：1045 K

文摘

To compare rim area rates in patients with and without the visual field (VF) progression endpoint in the Canadian Glaucoma Study and determine whether intraocular pressure (IOP) reduction following the endpoint altered rim area rate.

Design

Prospective multicenter cohort study.

Methods

setting: University hospitals. patient population: Two hundred and six patients with open-angle glaucoma were examined at 4-month intervals with standard automated perimetry and confocal scanning laser tomography. intervention: After the endpoint, IOP was reduced by ≥20%. outcome measures: Univariate analysis for change in rim area rate and multivariable analysis to adjust for independent covariates (eg, age, sex, and IOP).

Results

Patients with an endpoint (n = 59) had a worse rim area rate prior to the endpoint compared to those without (n = 147; median [interquartile range]: −14 [−32, 11] × 10⁻³ mm²/y and −5 [−14, 5] × 10⁻³ mm²/y, respectively, P = .02). In univariate analysis, there was no difference in rim area rate before and after the endpoint (median difference [95% CI], 8 (−10, 24) × 10⁻³ mm²/y), but the muItivariate analysis showed that IOP reduction >2 mm Hg after the endpoint was strongly linked to a reduction in rim area rate decline (8 × 10⁻³ mm²/y for each additional 1 mm Hg reduction).

Conclusions

Patients with a VF endpoint had a median rim area rate that was nearly 3 times worse than those without an endpoint. Lower mean follow-up IOP was independently associated with a slower decline in rim area.