Progression of visual field in patients with primary open-angle glaucoma - ProgF study 1

Purpose: To evaluate the visual field rate of progression of patients with treated ocular hypertension (OHT) and primary open-angle glaucoma (POAG) in clinical practice, using the mean deviation (MD) and the visual field index (VFI). Methods: Non-interventional cohort study. From a large multicentre database representative of the French population, 441 eyes of 228 patients with treated OHT or POAG followed up at least 6 years with Humphrey 24.2 Sita-Standard visual field examination at least twice a year were identified. From initial data, eyes were classified in five groups: 121 with OHT, 188 with early glaucoma (MD greater than -6 dB), 45 with moderate glaucoma (MD -6 to -12 dB), 41 with advanced glaucoma (MD -12 to -18 dB) and 46 with severe glaucoma (MD less than -18 dB). Rate of progression during the follow-up period was calculated using the trend analysis of the Guided Progression Analysis software. Results: The mean duration of follow-up was 8.4 +/- 2.7 years and the mean number of visual field, 18.4 +/- 3.5. In eyes with OHT, rate of progression was -0.09 dB/year (-0.17% VFI/year). In eyes with POAG, rate of progression was -0.32 dB/year (-0.83% VFI/year) in eyes with early glaucoma, -0.52 dB/year (-1.81% VFI/year) in moderate glaucoma, -0.54 dB/year (-2.35% VFI/year) in advanced glaucoma and -0.45 dB/year (-1.97% VFI/year) in severe glaucoma. In eyes with POAG, a significant progression (p < 0.05) was detected in 159 of 320 eyes (49.7%) with trend analysis and 117 of 320 eyes (36.6%, likely progression) or 183 of 320 eyes (57.2%, possible and likely progression) with event analysis. Conclusions: Primary open-angle glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow-up. The rate of progression varies greatly among subjects.