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<p>To evaluate the rate and determinants of visual field (VF) progression across different severities of primary angle-closure glaucoma (PACG). Chinese patients with PACG who had ≥ 5 reliable VFs and ≥ 5 years of follow-up were included. Disease severity was classified by baseline mean deviation (MD) as mild (≥-6.0dB), moderate (-6.01 to -12.0dB) or severe (&lt;-12.0dB). VF progression was categorized as slow (&gt;-0.25dB/year), intermediate (-0.25 to -1.0dB/year), or fast (≤-1.0dB/year). Among 783 patients evaluated, 477 met the inclusion criteria: 140 (29.4%) mild, 161 (33.8%) moderate, and 176 (36.9%) severe PACG. Most eyes showed slow progression (n = 248, 52.0%), followed by intermediate (n = 164, 34.4%) and fast (n = 65, 13.6%). Moderate PACG progressed fastest (-0.45 ± 0.80dB/year), compared with mild (-0.39 ± 0.54dB/year) and severe disease (-0.12 ± 1.12dB/year) (p &lt; 0.001), demonstrating a U-shaped relationship between disease severity and progression. In mild PACG, a longer interval to cataract surgery was associated with reduced odds of slow progression (OR, 0.90; 95% CI, 0.81-1.00, p = 0.05). In moderate PACG eyes, females and poorer presenting visual acuity were associated with slow progression (OR, 3.12; 95% CI, 1.33–7.72; p = 0.01 and OR, 5.54; 95% CI, 1.37–26.50; p = 0.02 respectively). In severe PACG, females and higher presenting IOP were associated with slow progression (OR, 2.63; 95% CI, 1.20–5.97; p = 0.02 and OR, 1.06; 95% CI, 1.01–1.11; p = 0.02 respectively). VF progression in PACG patients demonstrated a U-shaped relationship with disease severity, with moderate PACG exhibiting the fastest progression. Determinants of progression differed for different severities of PACG, highlighting the importance of stage-specific treatment of PACG. </p>

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Visual field progression in varying severities of treated patients with primary angle closure glaucoma

  • 期刊论文

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  • 发表日期：

    2026年4月1日

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  • Shayne S. Tan,
  • Tan See Teng,
  • Shimna Prasad,
  • Stella Jinran Zhan,
  • Qiao Fan,
  • Kaila Boh,
  • Ronnie George,
  • Mani Baskaran,
  • Tina T. Wong,
  • Shamira Perera,
  • Tin Aung,
  • Monisha Esther Nongpiur

摘要

To evaluate the rate and determinants of visual field (VF) progression across different severities of primary angle-closure glaucoma (PACG). Chinese patients with PACG who had ≥ 5 reliable VFs and ≥ 5 years of follow-up were included. Disease severity was classified by baseline mean deviation (MD) as mild (≥-6.0dB), moderate (-6.01 to -12.0dB) or severe (<-12.0dB). VF progression was categorized as slow (>-0.25dB/year), intermediate (-0.25 to -1.0dB/year), or fast (≤-1.0dB/year). Among 783 patients evaluated, 477 met the inclusion criteria: 140 (29.4%) mild, 161 (33.8%) moderate, and 176 (36.9%) severe PACG. Most eyes showed slow progression (n = 248, 52.0%), followed by intermediate (n = 164, 34.4%) and fast (n = 65, 13.6%). Moderate PACG progressed fastest (-0.45 ± 0.80dB/year), compared with mild (-0.39 ± 0.54dB/year) and severe disease (-0.12 ± 1.12dB/year) (p < 0.001), demonstrating a U-shaped relationship between disease severity and progression. In mild PACG, a longer interval to cataract surgery was associated with reduced odds of slow progression (OR, 0.90; 95% CI, 0.81-1.00, p = 0.05). In moderate PACG eyes, females and poorer presenting visual acuity were associated with slow progression (OR, 3.12; 95% CI, 1.33–7.72; p = 0.01 and OR, 5.54; 95% CI, 1.37–26.50; p = 0.02 respectively). In severe PACG, females and higher presenting IOP were associated with slow progression (OR, 2.63; 95% CI, 1.20–5.97; p = 0.02 and OR, 1.06; 95% CI, 1.01–1.11; p = 0.02 respectively). VF progression in PACG patients demonstrated a U-shaped relationship with disease severity, with moderate PACG exhibiting the fastest progression. Determinants of progression differed for different severities of PACG, highlighting the importance of stage-specific treatment of PACG.