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Risk Factors for Visual Field Deterioration in the United Kingdom Glaucoma Treatment Study
- Source :
- Ophthalmology. 127:1642-1651
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Objective The United Kingdom Glaucoma Treatment Study (UKGTS) investigated the visual field (VF) preserving effect of medical treatment in open-angle glaucoma (OAG). The objective of this analysis was to identify risk factors associated with VF deterioration. Design Randomized, double masked, placebo-controlled, multicentre trial. Participants Five hundred sixteen participants with previously untreated OAG were prospectively recruited in 10 UK centres. Methods Eligibility criteria were modeled on those for the Early Manifest Glaucoma Trial. Study participants were randomized to either latanoprost 0.005% or placebo eye drops. The observation period was 2 years and involved, among other procedures, VF testing and intraocular pressure (IOP) measurement at 11 scheduled visits, with clustering of tests at baseline, 18 months, and 24 months. Guided Progression Analysis pattern deviation maps were used to determine VF deterioration. Cox regression was used to compute the hazard ratios (HRs) and respective 95% confidence intervals (CIs) whilst accounting for the correlation within sites. Model selection was guided by backwards stepwise selection conducted on the model containing all variables which were significant at the 0.2 level in the univariable analysis. Follow-up variables which showed collinearity with baseline values were not retained in the final model. Main outcome measures Time-to-VF deterioration. Results Treatment with latanoprost reduced the HR for VF deterioration by 58% (HR 0.42; 95% CI 0.27-0.67, P=0.001). Factors associated with deterioration were bilateral disease (HR 1.59 for yes versus no; 95% CI 1.02-2.50, P=0.041), higher baseline IOP (HR 1.07 per mmHg; 95% CI 1.02-1.12, P=0.008) and disc haemorrhage at visit 1 (HR 2.08; 95% CI 1.07-4.04, P=0.030). Smoking (current or previous) was associated with a reduced HR for VF deterioration (HR 0.59; 95% CI 0.37-0.93, P=0.023). No other evaluated factors were found to be statistically significant in the multivariable analysis. Conclusions In the UKGTS, treatment with latanoprost halved VF deterioration risk. Bilateral disease, higher IOP and disc haemorrhage were confirmed as risk factors for deterioration; smoking history appeared to be protective against VF deterioration.
- Subjects :
- Adult
Male
medicine.medical_specialty
Intraocular pressure
genetic structures
Vision Disorders
Glaucoma
Administration, Ophthalmic
Placebo
law.invention
Tonometry, Ocular
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Double-Blind Method
Randomized controlled trial
Risk Factors
law
Internal medicine
medicine
Humans
Prospective Studies
Latanoprost
Antihypertensive Agents
Intraocular Pressure
Aged
030304 developmental biology
0303 health sciences
Proportional hazards model
business.industry
Hazard ratio
Middle Aged
medicine.disease
United Kingdom
Confidence interval
Ophthalmology
chemistry
030221 ophthalmology & optometry
Visual Field Tests
Female
Ophthalmic Solutions
Visual Fields
business
Glaucoma, Open-Angle
Subjects
Details
- ISSN :
- 01616420
- Volume :
- 127
- Database :
- OpenAIRE
- Journal :
- Ophthalmology
- Accession number :
- edsair.doi.dedup.....059fc806eb44c66cac7f328476b61f8c