Asymmetries and visual field summaries as predictors of glaucoma in the ocular hypertension treatment study

Richard A. Levine, Shaban Demirel, Juanjuan Fan, John L. Keltner, Chris A. Johnson, Michael A. Kass, Donald L. Budenz, Francisco E. Fantes, Steven J. Gedde, Richard K. Parrish, Madeline L. Del Calvo, Thomas S. Harbin, Paul McManus, Charles J. Patorgis, Montana L. Hooper, Stacey S. Goldstein, Debbie L. Lee, Lea Morton, Marianne L. Perry, Teresa A. LongShelly R. Smith, Julie M. Wright, Ronald L. Gross, Silvia Orengo-Nania, Pamela M. Frady, Benita D. Slight, George A. Cioffi, Annisa L. Jamil, Steven Mansberger, Emily L. Patterson, Kathryn Sherman, Jo Anne M. Fraser, Allen D. Beck, Anastasias Costarides, Camilele M. Hylton, Donna Leef, Nauman R. Imami, Deborah Darnley-Fisch, Aldo Fantin, Melanie Gutkowski, Elizabeth Carnegie, Sheila Rock, Donald J. Zack, Donald A. Abrams, Nathan G. Congdon, Robert A. Copeland, David S. Friedman, Ramzi Hemady, Eve J. Higginbotham, Henry D. Jampel, Irvin P. Pollack, Harry A. Quigley, Alan L. Robin, Rachel Scott, Felicia Keel, Lisa Levin, Kevin L. Powdrill, Robyn Priest-Reed, Anne L. Coleman, Richard S. Baker, Y. P. Dang, Jo Ann A. Giaconi, Simon K. Law, Bobbie Ballenberg, Salvador Murillo, Manju Sharma, Terry J. Bergstrom, Christina A. Bruno, Sayoko E. Moroi, Carol J. Pollack-Rundle, Michelle A. Tehranisa, Bret A. Hughes, Monica Y. Allen, Mark S. Juzych, Mark L. McDermott, John M. Ramocki, Juan Allen, Laura L. Schulz, John M. O'Grady, Linda A. Van Conett, Mary B. Hall, Joern B. Soltau, Judit Mohay, Robb R. Shrader, Sandy Lear, David C. Herman, Douglas H. Johnson, Becky A. Nielsen, Nancy J. Tvedt, Jeffrey M. Liebmann, Robert Ritch, Celso A. Tello, Jean L. Walker, Nina C. Mondoc, Deborah L. Simon, Paul Weber, N. Douglas Baker, Robert J. Derick, David Lehmann, Kathyrne McKinney, Diane Moore, G. Richard Bennett, Myron Yanoff, Lindsay C. Bennett, Mary Jameson, Jody R. Piltz-Seymour, Hina N. Ahmed, Eydie G. Miller, Prithvi S. Sankar, Cheryl McGill, Janice T. Petner, James D. Brandt, Jeffrey J. Casper, Michele C. Lim, Ivan R. Schwab, Ingrid J. Clark, Denise M. Owensby, Marilyn A. Sponzo, Robert N. Weinreb, J. Rigby Slight, Osaro A. Okuonghae, Michael V. Drake, Allan J. Flach, Shan C. Lin, Robert Stamper, Fermin P. Ballesteros, Valerie Margol, Kathleen A. Lamping, Cheryl L. Vitelli, Bettina J. Modica, Douglas E. Gaasterland, Robin L. Montgomery, Frank S. Ashburn, Karen D. Schacht, Arthur L. Schwartz, Howard S. Weiss, Clete Clark, Anne M. Boeckl, Edward M. Barnett, Bernard Becker, Anjali M. Bhorade, Allan E. Kolker, Carla J. Siegfried, Sandra Quirin, Fortunata Darmody, Douglas R. Anderson, Donald F. Everett, Mae E. Gordon, Dale K. Heuer, John A. Keltner, M. Roy Wilson, Patricia A. Morris, Teresa A. Roediger, John Connett, Claude Cowan, Barry Davis, Jo Anne Katz, Ronald Munson, Mark Sherwood, Gregory L. Skuta, Dale K. Heur, Steven Kymes, J. Philip Miller, Mary Bednarski, Julia Beiser, Karen Clark, Betsy Hornbeck, Ellen Long, Deborah Dunn, Maria Cristina Wells-Albornoz, Ruth Vandenbroucke, Heather Johnson, William Feuer, Joyce Schiffman, Ditte Hess, Kimberly E. Cello, Shannan E. Bandermann, Bhupinder S. Dhillon, Linda Zangwill, Keri Dirkes, Pamela A. Sample, William M. Bourne

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46 Scopus citations

Abstract

PURPOSE. To evaluate whether baseline visual field data and asymmetries between eyes predict the onset of primary open-angle glaucoma (POAG) in Ocular Hypertension Treatment Study (OHTS) participants. METHODS. A new index, mean prognosis (MP), was designed for optimal combination of visual field thresholds, to discriminate between eyes that developed POAG from eyes that did not. Baseline intraocular pressure (IOP) in fellow eyes was used to construct measures of IOP asymmetry. Age-adjusted baseline thresholds were used to develop indicators of visual field asymmetry and summary measures of visual field defects. Marginal multivariate failure time models were constructed that relate the new index MP, IOP asymmetry, and visual field asymmetry to POAG onset for OHTS participants. RESULTS. The marginal multivariate failure time analysis showed that the MP index is significantly related to POAG onset (P < 0.0001) and appears to be a more highly significant predictor of POAG onset than either mean deviation (MD; P = 0.17) or pattern standard deviation (PSD; P = 0.046). A 1-mm Hg increase in IOP asymmetry between fellow eyes is associated with a 17% increase in risk for development of POAG. When threshold asymmetry between eyes existed, the eye with lower thresholds was at a 37% greater risk of development of POAG, and this feature was more predictive of POAG onset than the visual field index MD, though not as strong a predictor as PSD. CONCLUSIONS. The MP index, IOP asymmetry, and binocular test point asymmetry can assist in clinical evaluation of eyes at risk of development of POAG.

Original languageEnglish
Pages (from-to)3896-3903
Number of pages8
JournalInvestigative Ophthalmology and Visual Science
Volume47
Issue number9
DOIs
StatePublished - Sep 2006

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