Canadian Glaucoma Study: 2. risk factors for the progression of open-angle glaucoma

Arch Ophthalmol. 2008 Aug;126(8):1030-6. doi: 10.1001/archopht.126.8.1030.


Objective: To determine systemic and ocular risk factors for visual field progression in open-angle glaucoma.

Methods: In the Canadian Glaucoma Study, a multicenter prospective longitudinal study of 258 patients (131 men and 127 women; median age, 65.0 years), baseline systemic measures included assessment of peripheral vasospasm and markers for hematopathology, coagulopathy, and immunopathology. Patients were followed up at 4-month intervals with perimetry, optic disc imaging, and a standardized interventional protocol for intraocular pressure control. Univariate and proportional hazards models were used to identify factors that predicted progression.

Main outcome measure: Visual field progression with standard automated perimetry.

Results: Median follow-up was 5.3 years, with 167 patients (64.7%) completing 5 years or more and 67 patients (26.0%) completing 7 years or more. Abnormal baseline anticardiolipin antibody levels (hazard ratio [HR], 3.86; 95% confidence interval [CI], 1.60-9.31), higher baseline age (HR per year, 1.04; 95% CI, 1.01-1.07), female sex (HR, 1.94; 95% CI, 1.09-3.46), and higher mean follow-up intraocular pressure (HR per 1 mm Hg, 1.19; 95% CI, 1.05-1.36) before progression were associated with progression.

Conclusions: The Canadian Glaucoma Study identified 4 independent predictive factors for glaucomatous field progression. Application to Clinical Practice While confirming the importance of intraocular pressure in glaucoma progression, this study determined other risk factors that merit awareness.

Trial registration: NCT00262626.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Flow Velocity
  • Disease Progression
  • Female
  • Fingers / blood supply
  • Follow-Up Studies
  • Glaucoma, Open-Angle / diagnosis
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Intraocular Pressure*
  • Laser-Doppler Flowmetry
  • Male
  • Middle Aged
  • Optic Nerve Diseases / diagnosis
  • Optic Nerve Diseases / physiopathology*
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Factors
  • Tomography, Optical Coherence
  • Vision Disorders / diagnosis
  • Vision Disorders / physiopathology*
  • Visual Field Tests
  • Visual Fields*

Associated data