Predictive Factors for Progressive Optic Nerve Damage in Various Types of Chronic Open-angle Glaucoma
Accepted 20 December 2004. published online 06 May 2005.
Purpose
To evaluate whether various types of chronic open-angle glaucoma differ in predictive factors for progression of glaucomatous optic nerve damage.
Design
Observational cohort study.
Methods
setting: Prospective observational clinical study. patients: 517 eyes of 300 Caucasian patients with chronic open-angle glaucoma with elevated intraocular pressure (primary open-angle glaucoma, n = 289; secondary open-angle glaucoma, n = 50) and with normal intraocular pressure (n = 178). observation procedure: During follow-up (median: 49 months, 6 months-130 months), all patients underwent repeated evaluation of color stereo optic disk photographs and white-on-white visual field examination. main outcome measures: Progression of glaucoma was defined as neuroretinal rim loss during the study period.
Results
For patients with elevated intraocular pressure, significantly predictive factors for eventual progression were older age, advanced perimetric damage, smaller neuroretinal rim, and larger area of β zone of parapapillary atrophy. In contrast, in the normal intraocular pressure group, a significant predictive factor was presence of disk hemorrhages at baseline. Within the patients with elevated intraocular pressure, the primary open-angle glaucoma group and the secondary open-angle glaucoma group did not differ in predictive factors for progression of glaucoma.
Conclusions
Open-angle glaucoma patients with normal intraocular pressure and open-angle glaucoma patients with elevated intraocular pressure differ in predictive factors for eventual progression of glaucomatous optic nerve damage. It may have clinical importance and may be helpful in the discussion of the pathogenesis of the glaucomas.
aDepartment of Medical Informatics, Biometry, and Epidemiology, Charité University Medicine Berlin, Berlin, Germany
cDepartment of Ophthalmology and Eye Hospital, University Erlangen-Nürnberg, Erlangen, Germany
dDepartment of Ophthalmology, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany
Inquiries to Dr. Peter Martus, Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany; fax: 49-(0)30-8445-4471
Supported by Deutsche Forschungsgemeinschaft DFG (SFB 539), Bonn, Germany.
ABSTRACT