Basal evaluation and rates of progression based on visual fields in six different glaucoma types of a large population

Purpose The aim of this study is to analyze the distribution of visual field (VF) mean defect (MD) in six subgroups of glaucoma patients at baseline and follow-up. Methods We assessed glaucoma patients treated in a Spanish tertiary care setting with a follow-up of at least 10 months. We have included 1036 visual fields and the following glaucoma subtypes: open-Angle Glaucoma (OAG); Angle-Closure Glaucoma (ACG); Congenital Glaucoma (CG); Ocular hypertension (OHT); Pseudoexfoliative Glaucoma (PSXG); Pigmentary Glaucoma (PG). We have calculated the baseline MD and the progression MD. We have stratified the MD progression in slow (MD rate > -0.5 dB/year); moderate (MD rate between -0.5 and -1 dB/year) fast (MD rate between -1 and -2 dB/year) and catastrophic (<-2 dB/year) progression and their glaucoma subtype. Results The glaucoma types with the worse baseline MD were CG and PG. We found significant differences after comparing the baseline MD of CG and OAG, ACG, OHT and between PG and OHT. Concerning the MD progression rate: OAG 73.54% showed slow MD progression rate; 9.85% fast; 7.3% moderate and 9.3% catastrophic. ACG 82.22% slow; 8.89% moderate; 2.22% fast and 6.67% catastrophic. CG 68.83% slow; 9.09% fast; 7.79% moderate and 14.29% catastrophic. OHT 88.6% slow; 6.14% moderate; 4.39% fast and 0.88% catastrophic. PSXG 63.24% slow, 13.24% moderate; 8.8% fast and 14.7% catastrophic. PG 89.29% slow; 3.57% moderate and 7.1% fast. Conclusions The CG requires special attention because of its aggressive presentation and progression.

Automated summary

The purpose of this study is to analyze the distribution of visual field mean defect (MD) in different subgroups of glaucoma patients and their progression over time. A total of 1036 visual fields were assessed in glaucoma subtypes including open-angle glaucoma, angle-closure glaucoma, congenital glaucoma, ocular hypertension, pseudoexfoliative glaucoma, and pigmentary glaucoma. The study found that congenital glaucoma and pigmentary glaucoma had the worst baseline MD and that congenital glaucoma showed an aggressive progression. The findings emphasize the importance of special attention to the management of congenital glaucoma.