Factors associated with visual loss in patients with advanced glaucomatous changes in the optic nerve head

Am J Ophthalmol. 1993 Aug 15;116(2):176-81. doi: 10.1016/s0002-9394(14)71282-6.


We evaluated factors associated with decreased or stable visual function in 72 patients with primary open-angle glaucoma and complete cupping of the optic disk who were followed up five years or more. We found a significantly lower mean (15.4 +/- 2.7 mm Hg) and peak (24.5 +/- 6.9 mm Hg) intraocular pressure in those patients whose vision remained stable vs those whose vision decreased (21.3 +/- 3.2 and 39.2 +/- 11.0 mm Hg, respectively) (t-test, P < .001). Additionally, the variance of each patient's individual intraocular pressure readings measured during the follow-up period was lower in the group with stable vision (4.5 mm Hg) than in those in whom vision decreased (9.0 mm Hg) (F test, P < .001). Stepwise discriminant analysis disclosed that mean intraocular pressure, variance of an individual's intraocular pressure measurements over time, history of argon laser trabeculoplasty, and compliance with therapy discriminated 92.9% of patients (52 of 56) whose vision remained stable and 87.5% of patients (14 of 16) whose vision decreased. Reduction of intraocular pressure and compliance with therapy are important in patients with complete glaucomatous cupping of the optic disk.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Glaucoma, Open-Angle / complications*
  • Glaucoma, Open-Angle / physiopathology
  • Humans
  • Intraocular Pressure
  • Laser Therapy
  • Male
  • Middle Aged
  • Optic Disk / physiopathology*
  • Optic Nerve Diseases / etiology
  • Optic Nerve Diseases / physiopathology
  • Risk Factors
  • Trabeculectomy
  • Vision Disorders / etiology*
  • Vision Disorders / physiopathology
  • Visual Acuity / physiology
  • Visual Fields / physiology