TY - JOUR
T1 - The region of largest β-zone parapapillary atrophy area predicts the location of most rapid visual field progression
AU - Teng, Christopher C.
AU - De Moraes, Carlos Gustavo
AU - Prata, Tiago S.
AU - Liebmann, Craig A.
AU - Tello, Celso
AU - Ritch, Robert
AU - Liebmann, Jeffrey M.
N1 - Funding Information:
Financial Disclosures: Supported by an American Glaucoma Society Clinician Scientist Research Award (C.C.T.) San Francisco, California; the Pierre F. Simon Charitable Trust Research Fund of the New York Glaucoma Research Institute, New York, New York; and the Glaucoma Research and Education Fund of Lenox Hill Hospital, New York, New York (C.G.D.M.).
PY - 2011/12
Y1 - 2011/12
N2 - Purpose: To determine if visual field (VF) progression occurs most rapidly in the region of largest β-zone parapapillary atrophy (PPA). Design: Retrospective cohort. Participants: One hundred twenty-five patients from the New York Glaucoma Progression Study with both β-zone PPA and VF progression. Methods: Treated open-angle glaucoma patients with 8 or more Swedish Interactive Threshold Algorithm Standard 24-2 VFs (Humphrey Field Analyzer II; Carl Zeiss Meditec, Inc., Dublin, CA) in either eye were identified. Eyes with optic disc photographs, β-zone PPA, less than 6 diopters myopia, and VF progression were studied. Visual field progression was defined using trend analysis as the presence of at least 2 adjacent progressing points in the same hemifield using standard pointwise linear regression (PLR) criteria. Main Outcome Measures: The correlation between β-zone PPA and location of most rapid future VF progression. Results: One hundred twenty-five eyes (125 patients; mean age, 71.9±12.3 years; 58% women; 75% European descent) with β-zone PPA and VF progression were enrolled. The mean follow-up was 6.8±1.7 years and the mean number of VFs was 12.5±3.6. Ninety-three patients (74%) had more β-zone PPA inferiorly and 32 patients (26%) had more β-zone PPA superiorly. The fastest VF progression occurred in the superior hemifield in 77 patients (62%) and in the inferior hemifield in 48 (38%) patients. Patients with superior VF progression had a superior localized mean rate of progression of -1.57±1.7 dB/year, and patients with inferior VF progression had an inferior localized mean rate of -0.94±1.4 dB/year (P = 0.012). The mean number of points reaching the predefined PLR end points was 5.6±7.5 for the superior VF hemifield and 3.0±4.9 for the inferior hemifield (P = 0.006). The hemifield with more points reaching PLR progression end points, with fastest average velocity of progression, or both was spatially consistent with the location of largest β-zone PPA in 89 (71%) patients (P = 0.0001, Fisher exact test; κ = 0.35; 95% confidence interval, 0.170.53). Conclusions: In treated glaucoma patients with β-zone PPA and VF progression, the location of largest β-zone PPA typically correlates spatially with the region of the most rapid future VF progression.
AB - Purpose: To determine if visual field (VF) progression occurs most rapidly in the region of largest β-zone parapapillary atrophy (PPA). Design: Retrospective cohort. Participants: One hundred twenty-five patients from the New York Glaucoma Progression Study with both β-zone PPA and VF progression. Methods: Treated open-angle glaucoma patients with 8 or more Swedish Interactive Threshold Algorithm Standard 24-2 VFs (Humphrey Field Analyzer II; Carl Zeiss Meditec, Inc., Dublin, CA) in either eye were identified. Eyes with optic disc photographs, β-zone PPA, less than 6 diopters myopia, and VF progression were studied. Visual field progression was defined using trend analysis as the presence of at least 2 adjacent progressing points in the same hemifield using standard pointwise linear regression (PLR) criteria. Main Outcome Measures: The correlation between β-zone PPA and location of most rapid future VF progression. Results: One hundred twenty-five eyes (125 patients; mean age, 71.9±12.3 years; 58% women; 75% European descent) with β-zone PPA and VF progression were enrolled. The mean follow-up was 6.8±1.7 years and the mean number of VFs was 12.5±3.6. Ninety-three patients (74%) had more β-zone PPA inferiorly and 32 patients (26%) had more β-zone PPA superiorly. The fastest VF progression occurred in the superior hemifield in 77 patients (62%) and in the inferior hemifield in 48 (38%) patients. Patients with superior VF progression had a superior localized mean rate of progression of -1.57±1.7 dB/year, and patients with inferior VF progression had an inferior localized mean rate of -0.94±1.4 dB/year (P = 0.012). The mean number of points reaching the predefined PLR end points was 5.6±7.5 for the superior VF hemifield and 3.0±4.9 for the inferior hemifield (P = 0.006). The hemifield with more points reaching PLR progression end points, with fastest average velocity of progression, or both was spatially consistent with the location of largest β-zone PPA in 89 (71%) patients (P = 0.0001, Fisher exact test; κ = 0.35; 95% confidence interval, 0.170.53). Conclusions: In treated glaucoma patients with β-zone PPA and VF progression, the location of largest β-zone PPA typically correlates spatially with the region of the most rapid future VF progression.
UR - http://www.scopus.com/inward/record.url?scp=82755189505&partnerID=8YFLogxK
U2 - 10.1016/j.ophtha.2011.06.014
DO - 10.1016/j.ophtha.2011.06.014
M3 - Article
C2 - 21885127
AN - SCOPUS:82755189505
SN - 0161-6420
VL - 118
SP - 2409
EP - 2413
JO - Ophthalmology
JF - Ophthalmology
IS - 12
ER -