Canadian Glaucoma Study: 3. Impact of risk factors and intraocular pressure reduction on the rates of visual field change

Arch Ophthalmol. 2010 Oct;128(10):1249-55. doi: 10.1001/archophthalmol.2010.196. Epub 2010 Aug 9.


Objectives: To determine rates of visual field change associated with risk factors for progression in the Canadian Glaucoma Study (abnormal anticardiolipin antibody level, age, female sex, and mean follow-up intraocular pressure [IOP]), and to evaluate the effect of IOP reduction on subsequent rates of visual field change in progressing patients.

Methods: Two hundred sixteen patients (median age, 65.2 years) were followed up at 4-month intervals with perimetry and were monitored for progression. Patients reaching an end point based on total deviation analysis underwent 20% or greater reduction in IOP. Rates of mean deviation (MD) change were calculated.

Results: Patients with 0, 1, and 2 end points had a median of 18, 23, and 25 examinations, respectively. The median MD rate in progressing patients prior to the first end point was significantly worse compared with those with no progression (-0.35 and 0.05 dB/y, respectively). An abnormal anticardiolipin antibody level was associated with a significantly worse MD rate compared with a normal anticardiolipin antibody level (-0.57 and -0.03 dB/y, respectively). Increasing age was associated with a worse MD rate, but female sex and mean follow-up IOP were not. After the first end point, the median IOP decreased from 18.0 to 14.8 mm Hg (20% in individual patients), resulting in a significant MD rate change from -0.36 to -0.11 dB/y.

Conclusions: Patients with abnormal anticardiolipin antibody levels and increasing age had faster visual field change. Modest IOP reduction in progressing patients significantly ameliorated the rate of visual field decline.

Trial registration: Identifier: NCT00262626.

Publication types

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

MeSH terms

  • Aged
  • Antibodies, Anticardiolipin / blood
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glaucoma, Open-Angle / immunology
  • Glaucoma, Open-Angle / physiopathology*
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Tonometry, Ocular
  • Vision Disorders / physiopathology*
  • Visual Acuity / physiology
  • Visual Field Tests
  • Visual Fields / physiology*


  • Antibodies, Anticardiolipin

Associated data