作者
Kenji Sugisaki,Toshihiro Inoue,Keiji Yoshikawa,Akira Kanamori,Yoshio Yamazaki,Shinichiro Ishikawa,Kenichi Uchida,Aiko Iwase,Makoto Araie,Makoto Araie,Atsuo Tomidokoro,Kenji Sugisaki,Ryo Asaoka,Hiroshi Murata,Hidenobu Tanihara,Masaru Inatani,Toshihiro Inoue,Keiji Yoshikawa,Akira Negi,Hidetaka Maeda,Akira Kanamori,Yuko Nakanish,Yoshio Yamazaki,Kenji Mizuki,Satoshi Okinami,Ryo Iwakiri,Shinichiro Ishikawa,Shun Matsumoto,Kenichi Uchida,Kōichi Mishima,Hotaka Nemoto,Aiko Iwase
摘要
To identify risk factors for further deterioration of central visual function in advanced glaucoma eyes.Prospective, observational 5-year study.Advanced glaucoma patients with well-controlled intraocular pressure (IOP), mean deviation (MD) of the Humphrey Field Analyzer (HFA) 24-2 program ≤-20 dB and best-corrected visual acuity (BCVA) of 20/40.The HFA 10-2 test and BCVA examination were performed every 6 months, and the HFA 24-2 test was performed every 12 months for 5 years. The Cox proportional hazards model was used to identify risk factors for deterioration of HFA 10-2 and 24-2 results and BCVA.Deterioration of HFA 10-2 results was defined by the presence of the same ≥3 points with negative total deviation slope ≤-1 dB/year at P < 0.01 on ≥3 consecutive tests, deterioration of HFA 24-2 results by an increase ≥2 in the Advanced Glaucoma Intervention Study score on ≥2 consecutive tests, and deterioration of BCVA by an increase of ≥0.2 logarithm of the minimum angle of resolution (logMAR) on ≥2 consecutive tests.A total of 175 eyes of 175 patients (mean age, 64.1 years; mean baseline IOP, 13.2 mmHg; mean BCVA, 0.02 logMAR; mean HFA 24-2 and 10-2 MD, -25.9 and -22.9 dB, respectively) were included. The probabilities of deterioration in HFA 10-2 and 24-2 results and BCVA were 0.269 ± 0.043 (standard error), 0.173 ± 0.031, and 0.194 ± 0.033, respectively, at 5 years. Lower BCVA at baseline (P = 0.012) was associated significantly with further deterioration of HFA 10-2 results. Better HFA 24-2 MD (P < 0.001) and use of systemic antihypertensive agents (P = 0.009) were associated significantly with further deterioration of HFA 24-2 results, and a greater β-peripapillary atrophy area-to-disc area ratio (P < 0.001), use of systemic antihypertensive agents (P = 0.025), and lower BCVA (P = 0.042) were associated significantly with further deterioration of BCVA, respectively.In advanced glaucoma eyes with well-controlled IOP, BCVA, β-peripapillary atrophy area-to-disc area ratio, and use of systemic antihypertensive agents were significant prognostic factors for further deterioration of central visual function.