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Visual Field Progression in the Ocular Hypertension Treatment Study.
American Journal of Ophthalmology ( IF 4.1 ) Pub Date : 2024-12-06 , DOI: 10.1016/j.ajo.2024.11.017
Mae O Gordon,Dale K Heuer,Eve J Higginbotham,Richard K Parrish,Lei Liu,James D Brandt,Julia B Huecker,J Phillip Miller,Chamila Perera,Chris Xie,John L Keltner,Chris A Johnson,Stuart K Gardiner,Jeffrey M Liebmann,Michael A Kass

PURPOSE To determine the rate of visual field (VF) loss before and after the diagnosis of primary open angle glaucoma (POAG) in the Ocular Hypertension Treatment Study (OHTS). DESIGN Pre-specified analyses of data collected prospectively in a clinical trial with extended follow-up. SETTING AND PARTICIPANTS Participants who developed POAG during OHTS 1 and 2 (February 1994 to December 2008) constitute an inception cohort. Follow-up data were collected in OHTS 3 (January 2016 to April 2019). Analyses were performed from July 2021 to August 2022. INTERVENTION In OHTS 1 and 2, visual field (VF) tests were performed every 6 months and stereoscopic optic disc photographs were taken every 12 months. These tests were repeated in OHTS 3. MAIN OUTCOMES AND MEASURES Slopes of mean deviation (MD) were calculated by linear regression for all eyes in OHTS 1 and 2: eyes that did not develop POAG, eyes that developed optic disc POAG only, and eyes that developed VF POAG with/without optic disc POAG. Mean pre- and post-POAG slopes were calculated for eyes with a minimum of 5 VFs for each period. RESULTS Mean age at diagnosis of POAG was 66.4 ± 9.5 SD years (n= 282 participants), (56%) were male, 61% were White non-Hispanic and 32% were Black not Hispanic by self-report. The post-POAG slope was -0.40 ± 0.64 SD dB/year for all POAG eyes (n=280 eyes), -0.19 ± 0.4 SD dB/yr. for optic disc POAG only eyes (n=112 eyes), and -0.54 ± 0.7 SD dB/yr. for VF POAG eyes with or without optic disc POAG (n=168 eyes). Among the VF POAG eyes, 69 (41%) had post-POAG MD slopes worse than or equal to -0.5 dB/year, 35 (21%) had slopes worse than or equal to -1.0 dB/year, and 9 (5.4%) had slopes worse than or equal to -2.0 dB/year. CONCLUSIONS AND RELEVANCE Some participants in OHTS had rapid rates of VF loss in one or both eyes despite being followed in a clinical study. This emphasizes that ocular hypertensive patients require careful follow-up, especially those at high risk of developing POAG to ensure early diagnosis and appropriate treatment of POAG.

中文翻译:


高眼压症治疗研究中的视野进展。



目的 确定高眼压症治疗研究 (OHTS) 中原发性开角型青光眼 (POAG) 诊断前后的视野 (VF) 丧失率。设计 对临床试验中前瞻性收集的数据进行预先指定的分析,并延长随访时间。环境和参与者 在 OHTS 1 和 2(1994 年 2 月至 2008 年 12 月)期间发生 POAG 的参与者构成了一个初始队列。在 OHTS 3 (2016 年 1 月至 2019 年 4 月) 中收集随访数据。分析于 2021 年 7 月至 2022 年 8 月进行。干预 在 OHTS 1 和 2 中,每 6 个月进行一次视野 (VF) 测试,每 12 个月拍摄一次立体视盘照片。这些测试在 OHTS 3 中重复进行。主要结局和措施 通过线性回归计算 OHTS 1 和 2 中所有眼睛的平均偏差 (MD) 斜率:未发生 POAG 的眼睛、仅发生视盘 POAG 的眼睛以及发生 VF POAG 伴/不伴视盘 POAG 的眼睛。计算每个时期至少 5 个 VF 的眼睛的平均 POAG 前后斜率。结果诊断为 POAG 的平均年龄为 66.4 ± 9.5 SD 年(n= 282 名参与者),(56%) 为男性,61% 为非西班牙裔白人,32% 为黑人非西班牙裔自我报告。所有 POAG 眼(n=280 只眼)的 POAG 后斜率为 -0.40 ± 0.64 SD dB/年,仅视盘 POAG 眼(n=112 眼)为 -0.19 ± 0.4 SD dB/年,VF POAG 眼有或没有视盘 POAG 的 -0.54 ± 0.7 SD dB/年(n=168 眼)。在 VF POAG 眼中,69 例 (41%) 的 POAG 后 MD 斜率差于或等于 -0.5 分贝/年,35 例 (21%) 的斜率差于或等于 -1.0 分贝/年,9 例 (5.4%) 的斜率差于或等于 -2.0 分贝/年。 结论和相关性 尽管在临床研究中进行了随访,但 OHTS 的一些参与者单眼或双眼的 VF 丢失率很快。这强调眼高血压患者需要仔细随访,尤其是那些患 POAG 风险高的患者,以确保 POAG 的早期诊断和适当治疗。
更新日期:2024-12-06
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