Progression of Visual Field Loss in Open Angle Glaucoma in the Melbourne Visual Impairment Project

Clin Exp Ophthalmol. Jan-Feb 2006;34(1):20-6. doi: 10.1111/j.1442-9071.2006.01142.x.


Purpose: To quantify the progression of visual field loss in participants with open angle glaucoma.

Methods: Cluster random samples of 3271 participants participated in this study. Each participant underwent a standardized ophthalmic examination, which included intraocular pressure measurement, Humphrey 24-2 Fastpac visual field testing and stereophotography of the optic disc. At baseline 118 participants were identified as possible, probable or definite open angle glaucoma and 74 (62.7%) of these were seen again at the follow-up examination. Progression of visual field loss was defined using three methods: the Advanced Glaucoma Intervention Study criteria, the modified Anderson criteria and the Blumenthal method.

Results: In total, 49% of subjects showed progressive visual field loss with at least one method. The Blumenthal criteria yielded the highest rate of progression (37%), followed by the modified Anderson method (33%) and the Advanced Glaucoma Intervention Study method (16%). The progressive visual field loss was associated with baseline glaucoma status (P = 0.02); 65% of the definite glaucoma progressed, compared with 57% of the probable glaucoma and 25% of the possible glaucoma. Participants who had been previously diagnosed with glaucoma had a higher rate of progression (54%) when compared with those who had not been diagnosed previously (47%). In total, 50% (four of eight) of those receiving glaucoma medication at baseline had progressive visual field loss; all were in the definite glaucoma category.

Conclusion: Despite use of glaucoma medications the majority of glaucoma patients managed by their regular ophthalmologist experienced progressive visual field loss over a 5-year period.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Diagnostic Techniques, Ophthalmological
  • Disease Progression
  • Female
  • Glaucoma, Open-Angle / complications*
  • Glaucoma, Open-Angle / physiopathology
  • Humans
  • Intraocular Pressure
  • Male
  • Middle Aged
  • Victoria
  • Vision Disorders / etiology*
  • Vision Disorders / physiopathology
  • Visual Fields*