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Results of long-term monitoring of normal-tension glaucoma patients receiving medical therapy: results of an 18-year follow-up

  • Glaucoma
  • Published:
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Abstract

Purpose

To conduct a ≥15-year follow-up assessment of the visual field (VF) in normal-tension glaucoma (NTG) patients receiving medical therapy and to identify risk factors for VF progression.

Design

A retrospective clinical study.

Methods

Medical records of 78 eyes of 78 NTG patients monitored for ≥15 years were reviewed. VF progression was defined by a mean deviation (MD) deteriorated twice by 3.00 dB from baseline (MD criterion) and an annual decrease in the MD slope exceeding −0.5 dB/year (MD slope criterion). Logistic regression analysis was employed to identify risk factors for VF progression.

Results

The mean follow-up period was 18.3 years. The average intraocular pressure (IOP) before treatment was 15.1 ±1.9 mmHg and the average treated IOP was 13.5 ±1.5 mmHg with 2.0 medications. Forty-two eyes (53.8%) showed VF progression using the MD criterion and 15 eyes (19.2%) showed a negative MD slope less than −0.5 dB/year. Disc hemorrhage (DH) was observed in 30 eyes (38.5%). The mean VF progression rate was −0.38 ±0.30 dB/year in the DH group and −0.24 ±0.28 dB/year in the non-DH group (P = 0.012). Multiple logistic regression analysis identified DH [relative risk (RR) 4.28; P = 0.028] as a risk factor for VF progression using the MD criterion. DH (RR 8.77; P = 0.007) and IOP fluctuation during follow-up (RR 5.03; P = 0.048) were detected as risk factors using the MD slope criterion.

Conclusions

DH and IOP fluctuation were associated with VF progression in NTG during long-term therapy.

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Acknowledgments

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Authors and Affiliations

  1. Department of Ophthalmology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu-shi, Japan, 501-1194

    Shinya Komori, Kyoko Ishida & Tetsuya Yamamoto

  2. Department of Ophthalmology, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu-shi, Japan, 500-8717

    Shinya Komori

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  1. Shinya Komori
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  2. Kyoko Ishida
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  3. Tetsuya Yamamoto
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Correspondence to Kyoko Ishida.

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Komori, S., Ishida, K. & Yamamoto, T. Results of long-term monitoring of normal-tension glaucoma patients receiving medical therapy: results of an 18-year follow-up. Graefes Arch Clin Exp Ophthalmol 252, 1963–1970 (2014). https://doi.org/10.1007/s00417-014-2767-3

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  • DOI: https://doi.org/10.1007/s00417-014-2767-3

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