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An Evidence-Based Review of Prognostic Factors for Glaucomatous Visual Field Progression.
MedLine Citation:
PMID:  23211636     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To examine which prognostic factors are associated with glaucomatous visual field progression. DESIGN: Knowledge of prognostic factors helps clinicians to select patients at risk of glaucomatous visual field progression and intensify their treatment. METHODS: By consulting relevant databases, we identified 2733 articles published up to September 2010, of which 85 articles investigating prognostic factors for visual field progression in patients with open-angle glaucoma (OAG) were eligible. We summarized results for each factor in tables, noting the direction of the association between the prognostic factor and progression, and the accompanying P value. Four authors, working blind to the factors, independently judged the extent to which a prognostic factor was associated with glaucomatous visual field progression. If there were different associations for normal-tension glaucoma (NTG) studies, they were judged separately. Consensus was reached during group meetings. MAIN OUTCOME MEASURES: The Main Outcome Measure of this review article is the ranking of a factor in the list of 103 presumed prognostic factors for glaucomatous visual field progression. These outcomes have been reported in the Results section of the Abstract. RESULTS: A total of 103 different prognostic factors were investigated in 85 articles. The following factors were clearly associated with glaucomatous visual field progression: age, disc hemorrhages (for NTG), baseline visual field loss, baseline intraocular pressure (IOP), and exfoliation syndrome. An association was unlikely for family history of glaucoma, atherosclerosis, systemic hypertension, visual acuity, sex (for NTG), systolic blood pressure, myopic refractive error (for NTG), and Raynaud's phenomenon. CONCLUSIONS: The factors we found clearly associated with progression could be used in clinical practice and for developing clinical prediction models. For many other factors, further research is necessary. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Authors:
Paul J Ernest; Jan S Schouten; Henny J Beckers; Fred Hendrikse; Martin H Prins; Carroll A Webers
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-1
Journal Detail:
Title:  Ophthalmology     Volume:  -     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Affiliation:
University Eye Clinic Maastricht, Maastricht, The Netherlands; Department of Epidemiology, Maastricht University, Maastricht, The Netherlands. Electronic address: p.j.g.ernest@gmail.com.
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