Acta Ophthalmologica 2015
Progression of visual field in patients with primary open-angle glaucoma – ProgF study 1 Florent Aptel,1 Nishal Aryal-Charles,1 Jean-Marie Giraud,2 Hussam El Chehab,2 Maxime Delbarre,2 Christophe Chiquet,1 Jean-Paul Romanet1 and Jean-Paul Renard2 1
Department of Ophthalmology, CHU Grenoble, Universite´ Grenoble Alpes, Grenoble, France Department of Ophthalmology, HIA du Val de Graˆce, Paris, France
2
ABSTRACT. 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. Key words: event analysis – glaucoma – ocular hypertension – progression – trend analysis – visual field
Acta Ophthalmol. 2015: 93: e615–e620 ª 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
doi: 10.1111/aos.12788
Introduction Many large clinical trials have evaluated the time–course of visual field defects in glaucomatous subjects and
demonstrated that most patients have visual field defects progression despite treatment and that the rates of progression varied greatly from one individual to other (Gliklich et al. 1989;
Collaborative Normal-Tension Glaucoma Study Group 1998; Membrey et al. 2000; Anderson et al. 2001; Eid et al. 2003; Leske et al. 2003; Heijl et al. 2009; Musch et al. 2009). Clinical trials evaluating the evolution in patients with treated glaucoma may differ from clinical practice for several reasons. Often, clinical trials include only a subset of subjects defined by strict inclusion criteria (e.g. early glaucoma na€ıve of any treatment, advanced glaucoma requiring filtering surgery). Patients included in the treated arm received a medical, laser or surgical treatment specified in advance and strictly codified, which may be different from what is done in clinical practice. The rhythm of follow-up visits and the number of examinations performed to research progression at each follow-up visit may also differ from what is done in practice. Finally, patient compliance to treatment and follow-up examinations is often better for various reasons (essentially motivated patients agreed to participate in a clinical trial, patients could receive money for participating, doctors encourage greatly patients to comply with the prescribed treatment and with follow-up visits, etc.). Only a few numbers of studies have evaluated the progression of visual field defects in glaucoma patients treated and followed by usual care. Most of these studies were performed in the U.S., and one in Sweden (De Moraes et al. 2009, 2010, 2011, 2013a, b; Folgar et al. 2010; Prata et al. 2010; Heijl et al. 2013). Taking advantage of a large computerized database including the medical and ophthalmic records
e615
Acta Ophthalmologica 2015
of hundreds of patients followed in two French centres for over 10 years, we aimed to study visual field progression and risk factors of progression in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients treated with the commonly used methods of treatment and followed in clinical ordinary practice. This should help the clinician to identify which patients require more care and might need a more aggressive treatment to achieve a better outcome. This first report focuses on the perimetric rate of progression at different stages of the disease.
Materials and Methods Data source and population studied
All patients with glaucoma followed in the Glaucoma Unit of the Grenoble University Hospital and the Val de Gr^ ace Military Hospital underwent a complete ophthalmic examination including visual field examinations as outpatients at least every 6 months. The patient’s data have been recorded in a computer database since 1998. All patients provided both verbal and written informed consent to have their data recorded. Data collection was authorized by the Commission Nationale Informatique et Libert e (CNIL), the French information technology and personal data protection authority. Ethics committee approval to analyse the data was obtained from an institutional review board (IRB 5891 no. 2013-25). Described research adhered to the tenets of the Declaration of Helsinki. Each semiannual examination included at least a medical and ocular history, refraction, best-corrected visual acuity, a Humphrey white on white visual field examination, Goldmann applanation tonometry, fundus examination and optic disc photographs. Patients are freely managed by the clinicians. In case of progression, clinicians were free to change medical treatment, perform argon or selective laser trabeculoplasty or perform incisional surgery. In case of cataract development, clinicians were free to perform cataract surgery. By searching this database, we identified patients who fulfilled the following inclusion criteria: (i) diagnosis of POAG defined as IOP >21 mmHg
e616
before or during diurnal curve measurement with or without glaucoma medications, gonioscopically open angle, consecutive and reliable abnormal standard automated perimetry with abnormal results on the Glaucoma Hemifield Test and pattern standard deviation outside 95% of normal limits, and optic nerve damage (asymmetric cup/disc ratio >0.2, rim thinning, notching, excavation or retinal nerve fibre layer defect), or diagnosis of OHT defined as IOP >21 mmHg before or during diurnal curve measurement with or without glaucoma medications, gonioscopically open angle, two consecutive and reliable normal standard automated perimetry, and normal optic disc; (ii) at least 12 consecutive complete follow-up visits spaced 6 1 months; (iii) complete ophthalmic examinations including a Humphrey Visual Field Analyzer (Zeiss-Humphrey Systems, Dublin, CA, USA) examination using the C-24-2 SITA standard strategy with reliable index during each of visits. A reliable visual field test was defined as having a 21 mmHg before or during diurnal curve measurement with or without glaucoma medications). This could have led to include more severe case of glaucoma, as previous studies have usually found a higher rate of progression in high-tension glaucoma that in normal tension glaucoma (Heijl et al. 2009). Strictly, patients called ‘POAG’ in our study should be compared to patients called ‘high-tension glaucoma’ in some of the previous studies conducted and above discussed (Heijl et al. 2009). This study has several notable clinical implications. It shows that a certain proportion of glaucoma patients has a rapid rate of progression from the beginning of the disease. It also shows that patients with more advanced glaucoma have a faster rate of progression. We could therefore hypothesize that the rate of progression of the patients having a fast rate of progression at the beginning of the disease often remains unchanged throughout the course of the disease, despite a very regular follow-up and care provided in a tertiary centre. Thus, those patients progress quickly to stages of moderate to advanced glaucoma, explaining that we found a faster rate of progression in patients with advanced glaucoma. Those patients are at risk to have a significant impact on their visual function and quality of life, and eventually to become blind. For these patients, with a fast rate of progression from the beginning of the disease, algorithms of treatment commonly used and advocating a gradual escalation of treatment are probably partially inadequate (Terminology and Guidelines for Glaucoma 2008; American Academy of Ophthalmology Glaucoma Panel 2010). It would probably be better to consider a more aggressive treatment early in the course of the disease, or at least as soon as the fast rate of progression is measured. In contrast, another significant part of glaucomatous subjects has a slow or nearly zero rate of progression. In these patients, less frequent follow-up could probably be enough, and we could be less prompt to consider a therapeutic climbing.
In conclusion, this study shows that glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow-up. The rate of progression varies greatly from one subject to another. Therefore, the initial MD and MD course observed at the beginning of the disease determine the future evolution profile, the risk of visual impairment and progression to blindness. Rather than applying a treatment and follow-up algorithm uniform in all patients, it could therefore be pertinent to consider the rate of progression measured in the early years of the follow-up, with consequent aggressive treatment immediately and a very close follow-up for those progressing quickly and vice versa for those progressing slowly.
References American Academy of Ophthalmology Glaucoma Panel (2010): Preferred practice pattern guidelines. Primary open-angle glaucoma. San Francisco, CA: American Academy of Ophthalmology. Available at: www.aao.org/ppp. Anderson DR, Drance SM & Schulzer M (2001): Natural history of normal-tension glaucoma. Ophthalmology 108: 247–253. Bertrand V, Fieuws S, Stalmans I & Zeyen T (2014): Rates of visual field loss before and after trabeculectomy. Acta Ophthalmol 92: 116–120. Chauhan BC, Mikelberg FS, Balaszi AG, LeBlanc RP, Lesk MR & Trope GE;CANADIANGLAUCOMASTUDYGROUP (2008): Canadian Glaucoma Study: 2. risk factors for the progression of open-angle glaucoma. Arch Ophthalmol 126: 1030–1036. Chauhan BC, Mikelberg FS, Artes PH et al. (2010): Canadian Glaucoma Study: 3. Impact of risk factors and intraocular pressure reduction on the rates of visual field change. Arch Ophthalmol 128: 1249– 1255. Choi YJ, Kim M, Park KH, Kim DM & Kim SH (2014): The risk of newly developed visual impairment in treated normal-tension glaucoma: 10-year follow-up. Acta Ophthalmol 92: e644–e649. Collaborative Normal-Tension Glaucoma Study Group (1998): The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Am J Ophthalmol 126: 498–505. De Moraes CG, Prata TS, Tello C, Ritch R & Liebmann JM (2009): Glaucoma with early visual field loss affecting both hemifields and the risk of disease progression. Arch Ophthalmol 127: 1129–1134. De Moraes CG, Ritch R & Liebmann JM (2010): Bridging the major prospective
e619
Acta Ophthalmologica 2015
national eye institute-sponsored glaucoma Clinical Trials and Clinical Practice. J Glaucoma 20: 1–2. De Moraes CG, Juthani V, Liebmann JM et al. (2011): Risk factors for visual field progression in treated glaucoma. Arch Ophthalmol 129: 562–568. De Moraes CG, Liebmann JM, Liebmann CA, Susanna R Jr, Tello C & Ritch R (2013a): Visual field progression outcomes in glaucoma subtypes. Acta Ophthalmol 91: 288– 293. De Moraes CG, Liebmann JM, Park SC et al. (2013b): Optic disc progression and rates of visual field change in treated glaucoma. Acta Ophthalmol 91: e86–e91. Eid TM, Spaeth GL, Bitterman A & Steinmann WC (2003): Rate and amount of visual loss in 102 patients with open-angle glaucoma followed up for at least 15 years. Ophthalmology 110: 900–907. Folgar FA, de Moraes CG, Prata TS et al. (2010): Glaucoma surgery decreases the rates of localized and global visual field progression. Am J Ophthalmol 149: 258–264. Gliklich RE, Steinmann WC & Spaeth GL (1989): Visual field change in low-tension glaucoma over a five-year follow-up. Ophthalmology 96: 316–320.
e620
Heijl A, Bengtsson B, Hyman L & Leske MC (2009): Natural history of open-angle glaucoma. Ophthalmology 116: 2271–2276. Heijl A, Buchholz P, Norrgren G & Bengtsson B (2013): Rates of visual field progression in clinical glaucoma care. Acta Ophthalmol 91: 406–412. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L & Komaroff E (2003): Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 121: 48–56. Membrey WL, Poinoosawmy DP, Bunce C, Fitzke FW & Hitchings RA (2000): Comparison of visual field progression in patients with normal pressure glaucoma between eyes with and without visual field loss that threatens fixation. Br J Ophthalmol 84: 1154–1158. Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK & CIGTS Study Investigators (2009): Visual field progression in the Collaborative Initial Glaucoma Treatment Study the impact of treatment and other baseline factors. Ophthalmology 116: 200– 207. de Pouvourville G & Chaine G (2007): La Demographie en Ophtalmologie 2000–2020. CAMTS 2007. Available at: www.ameli.fr/
l-assurance-maladie/statistiques-et-publica tions/collections-anterieures-a-2005/etudesmedico-economiques/soins-de-ville/la-demographie-en-ophtalmologie-2000-2020.php. Prata TS, De Moraes CG, Teng CC, Tello C, Ritch R & Liebmann JM (2010): Factors affecting rates of visual field progression in glaucoma patients with optic disc hemorrhage. Ophthalmology 117: 24–29. Terminology and Guidelines for Glaucoma (European Guidelines), 3rd edn. Savona: DOGMA 86–104, 2008 http://www.eugs. org/eng/EGS_guidelines.asp.
Received on September 9th, 2014. Accepted on May 21st, 2015. Correspondence: Florent Aptel Clinique Universitaire d’Ophtalmologie Centre Hospitalo Universitaire de Grenoble BP217, 38043 Grenoble Cedex 09 France Tel: + 33 (0)4 76 79 55 48 Fax: + 33 (0)4 76 76 75 70 Email: [email protected]
Progression of visual field in patients with primary open-angle glaucoma – ProgF study 1 Florent Aptel,1 Nishal Aryal-Charles,1 Jean-Marie Giraud,2 Hussam El Chehab,2 Maxime Delbarre,2 Christophe Chiquet,1 Jean-Paul Romanet1 and Jean-Paul Renard2 1
Department of Ophthalmology, CHU Grenoble, Universite´ Grenoble Alpes, Grenoble, France Department of Ophthalmology, HIA du Val de Graˆce, Paris, France
2
ABSTRACT. 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. Key words: event analysis – glaucoma – ocular hypertension – progression – trend analysis – visual field
Acta Ophthalmol. 2015: 93: e615–e620 ª 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
doi: 10.1111/aos.12788
Introduction Many large clinical trials have evaluated the time–course of visual field defects in glaucomatous subjects and
demonstrated that most patients have visual field defects progression despite treatment and that the rates of progression varied greatly from one individual to other (Gliklich et al. 1989;
Collaborative Normal-Tension Glaucoma Study Group 1998; Membrey et al. 2000; Anderson et al. 2001; Eid et al. 2003; Leske et al. 2003; Heijl et al. 2009; Musch et al. 2009). Clinical trials evaluating the evolution in patients with treated glaucoma may differ from clinical practice for several reasons. Often, clinical trials include only a subset of subjects defined by strict inclusion criteria (e.g. early glaucoma na€ıve of any treatment, advanced glaucoma requiring filtering surgery). Patients included in the treated arm received a medical, laser or surgical treatment specified in advance and strictly codified, which may be different from what is done in clinical practice. The rhythm of follow-up visits and the number of examinations performed to research progression at each follow-up visit may also differ from what is done in practice. Finally, patient compliance to treatment and follow-up examinations is often better for various reasons (essentially motivated patients agreed to participate in a clinical trial, patients could receive money for participating, doctors encourage greatly patients to comply with the prescribed treatment and with follow-up visits, etc.). Only a few numbers of studies have evaluated the progression of visual field defects in glaucoma patients treated and followed by usual care. Most of these studies were performed in the U.S., and one in Sweden (De Moraes et al. 2009, 2010, 2011, 2013a, b; Folgar et al. 2010; Prata et al. 2010; Heijl et al. 2013). Taking advantage of a large computerized database including the medical and ophthalmic records
e615
Acta Ophthalmologica 2015
of hundreds of patients followed in two French centres for over 10 years, we aimed to study visual field progression and risk factors of progression in primary open-angle glaucoma (POAG) and ocular hypertension (OHT) patients treated with the commonly used methods of treatment and followed in clinical ordinary practice. This should help the clinician to identify which patients require more care and might need a more aggressive treatment to achieve a better outcome. This first report focuses on the perimetric rate of progression at different stages of the disease.
Materials and Methods Data source and population studied
All patients with glaucoma followed in the Glaucoma Unit of the Grenoble University Hospital and the Val de Gr^ ace Military Hospital underwent a complete ophthalmic examination including visual field examinations as outpatients at least every 6 months. The patient’s data have been recorded in a computer database since 1998. All patients provided both verbal and written informed consent to have their data recorded. Data collection was authorized by the Commission Nationale Informatique et Libert e (CNIL), the French information technology and personal data protection authority. Ethics committee approval to analyse the data was obtained from an institutional review board (IRB 5891 no. 2013-25). Described research adhered to the tenets of the Declaration of Helsinki. Each semiannual examination included at least a medical and ocular history, refraction, best-corrected visual acuity, a Humphrey white on white visual field examination, Goldmann applanation tonometry, fundus examination and optic disc photographs. Patients are freely managed by the clinicians. In case of progression, clinicians were free to change medical treatment, perform argon or selective laser trabeculoplasty or perform incisional surgery. In case of cataract development, clinicians were free to perform cataract surgery. By searching this database, we identified patients who fulfilled the following inclusion criteria: (i) diagnosis of POAG defined as IOP >21 mmHg
e616
before or during diurnal curve measurement with or without glaucoma medications, gonioscopically open angle, consecutive and reliable abnormal standard automated perimetry with abnormal results on the Glaucoma Hemifield Test and pattern standard deviation outside 95% of normal limits, and optic nerve damage (asymmetric cup/disc ratio >0.2, rim thinning, notching, excavation or retinal nerve fibre layer defect), or diagnosis of OHT defined as IOP >21 mmHg before or during diurnal curve measurement with or without glaucoma medications, gonioscopically open angle, two consecutive and reliable normal standard automated perimetry, and normal optic disc; (ii) at least 12 consecutive complete follow-up visits spaced 6 1 months; (iii) complete ophthalmic examinations including a Humphrey Visual Field Analyzer (Zeiss-Humphrey Systems, Dublin, CA, USA) examination using the C-24-2 SITA standard strategy with reliable index during each of visits. A reliable visual field test was defined as having a 21 mmHg before or during diurnal curve measurement with or without glaucoma medications). This could have led to include more severe case of glaucoma, as previous studies have usually found a higher rate of progression in high-tension glaucoma that in normal tension glaucoma (Heijl et al. 2009). Strictly, patients called ‘POAG’ in our study should be compared to patients called ‘high-tension glaucoma’ in some of the previous studies conducted and above discussed (Heijl et al. 2009). This study has several notable clinical implications. It shows that a certain proportion of glaucoma patients has a rapid rate of progression from the beginning of the disease. It also shows that patients with more advanced glaucoma have a faster rate of progression. We could therefore hypothesize that the rate of progression of the patients having a fast rate of progression at the beginning of the disease often remains unchanged throughout the course of the disease, despite a very regular follow-up and care provided in a tertiary centre. Thus, those patients progress quickly to stages of moderate to advanced glaucoma, explaining that we found a faster rate of progression in patients with advanced glaucoma. Those patients are at risk to have a significant impact on their visual function and quality of life, and eventually to become blind. For these patients, with a fast rate of progression from the beginning of the disease, algorithms of treatment commonly used and advocating a gradual escalation of treatment are probably partially inadequate (Terminology and Guidelines for Glaucoma 2008; American Academy of Ophthalmology Glaucoma Panel 2010). It would probably be better to consider a more aggressive treatment early in the course of the disease, or at least as soon as the fast rate of progression is measured. In contrast, another significant part of glaucomatous subjects has a slow or nearly zero rate of progression. In these patients, less frequent follow-up could probably be enough, and we could be less prompt to consider a therapeutic climbing.
In conclusion, this study shows that glaucoma is a progressive disease in the majority of patients despite cautioned treatment and follow-up. The rate of progression varies greatly from one subject to another. Therefore, the initial MD and MD course observed at the beginning of the disease determine the future evolution profile, the risk of visual impairment and progression to blindness. Rather than applying a treatment and follow-up algorithm uniform in all patients, it could therefore be pertinent to consider the rate of progression measured in the early years of the follow-up, with consequent aggressive treatment immediately and a very close follow-up for those progressing quickly and vice versa for those progressing slowly.
References American Academy of Ophthalmology Glaucoma Panel (2010): Preferred practice pattern guidelines. Primary open-angle glaucoma. San Francisco, CA: American Academy of Ophthalmology. Available at: www.aao.org/ppp. Anderson DR, Drance SM & Schulzer M (2001): Natural history of normal-tension glaucoma. Ophthalmology 108: 247–253. Bertrand V, Fieuws S, Stalmans I & Zeyen T (2014): Rates of visual field loss before and after trabeculectomy. Acta Ophthalmol 92: 116–120. Chauhan BC, Mikelberg FS, Balaszi AG, LeBlanc RP, Lesk MR & Trope GE;CANADIANGLAUCOMASTUDYGROUP (2008): Canadian Glaucoma Study: 2. risk factors for the progression of open-angle glaucoma. Arch Ophthalmol 126: 1030–1036. Chauhan BC, Mikelberg FS, Artes PH et al. (2010): Canadian Glaucoma Study: 3. Impact of risk factors and intraocular pressure reduction on the rates of visual field change. Arch Ophthalmol 128: 1249– 1255. Choi YJ, Kim M, Park KH, Kim DM & Kim SH (2014): The risk of newly developed visual impairment in treated normal-tension glaucoma: 10-year follow-up. Acta Ophthalmol 92: e644–e649. Collaborative Normal-Tension Glaucoma Study Group (1998): The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Am J Ophthalmol 126: 498–505. De Moraes CG, Prata TS, Tello C, Ritch R & Liebmann JM (2009): Glaucoma with early visual field loss affecting both hemifields and the risk of disease progression. Arch Ophthalmol 127: 1129–1134. De Moraes CG, Ritch R & Liebmann JM (2010): Bridging the major prospective
e619
Acta Ophthalmologica 2015
national eye institute-sponsored glaucoma Clinical Trials and Clinical Practice. J Glaucoma 20: 1–2. De Moraes CG, Juthani V, Liebmann JM et al. (2011): Risk factors for visual field progression in treated glaucoma. Arch Ophthalmol 129: 562–568. De Moraes CG, Liebmann JM, Liebmann CA, Susanna R Jr, Tello C & Ritch R (2013a): Visual field progression outcomes in glaucoma subtypes. Acta Ophthalmol 91: 288– 293. De Moraes CG, Liebmann JM, Park SC et al. (2013b): Optic disc progression and rates of visual field change in treated glaucoma. Acta Ophthalmol 91: e86–e91. Eid TM, Spaeth GL, Bitterman A & Steinmann WC (2003): Rate and amount of visual loss in 102 patients with open-angle glaucoma followed up for at least 15 years. Ophthalmology 110: 900–907. Folgar FA, de Moraes CG, Prata TS et al. (2010): Glaucoma surgery decreases the rates of localized and global visual field progression. Am J Ophthalmol 149: 258–264. Gliklich RE, Steinmann WC & Spaeth GL (1989): Visual field change in low-tension glaucoma over a five-year follow-up. Ophthalmology 96: 316–320.
e620
Heijl A, Bengtsson B, Hyman L & Leske MC (2009): Natural history of open-angle glaucoma. Ophthalmology 116: 2271–2276. Heijl A, Buchholz P, Norrgren G & Bengtsson B (2013): Rates of visual field progression in clinical glaucoma care. Acta Ophthalmol 91: 406–412. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L & Komaroff E (2003): Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol 121: 48–56. Membrey WL, Poinoosawmy DP, Bunce C, Fitzke FW & Hitchings RA (2000): Comparison of visual field progression in patients with normal pressure glaucoma between eyes with and without visual field loss that threatens fixation. Br J Ophthalmol 84: 1154–1158. Musch DC, Gillespie BW, Lichter PR, Niziol LM, Janz NK & CIGTS Study Investigators (2009): Visual field progression in the Collaborative Initial Glaucoma Treatment Study the impact of treatment and other baseline factors. Ophthalmology 116: 200– 207. de Pouvourville G & Chaine G (2007): La Demographie en Ophtalmologie 2000–2020. CAMTS 2007. Available at: www.ameli.fr/
l-assurance-maladie/statistiques-et-publica tions/collections-anterieures-a-2005/etudesmedico-economiques/soins-de-ville/la-demographie-en-ophtalmologie-2000-2020.php. Prata TS, De Moraes CG, Teng CC, Tello C, Ritch R & Liebmann JM (2010): Factors affecting rates of visual field progression in glaucoma patients with optic disc hemorrhage. Ophthalmology 117: 24–29. Terminology and Guidelines for Glaucoma (European Guidelines), 3rd edn. Savona: DOGMA 86–104, 2008 http://www.eugs. org/eng/EGS_guidelines.asp.
Received on September 9th, 2014. Accepted on May 21st, 2015. Correspondence: Florent Aptel Clinique Universitaire d’Ophtalmologie Centre Hospitalo Universitaire de Grenoble BP217, 38043 Grenoble Cedex 09 France Tel: + 33 (0)4 76 79 55 48 Fax: + 33 (0)4 76 76 75 70 Email: [email protected]
