Liu, X;
Kelly, SR;
Montesano, G;
Bryan, SR;
Barry, RJ;
Keane, PA;
Denniston, AK;
(2019)
Evaluating the Impact of Uveitis on Visual Field Progression Using Large Scale Real-World Data.
American Journal of Ophthalmology
10.1016/j.ajo.2019.06.004.
(In press).
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Abstract
PURPOSE: To compare rates of visual field (VF) loss in uveitis patients with glaucoma against patients with primary open angle glaucoma (POAG) and explores the association between intraocular pressures (IOP) and rate of VF loss. Design; Retrospective cohort study. METHODS: Anonymized VFs and IOP measurements extracted from the EMR of 5 regionally different glaucoma clinics in England. A total of 205 eyes with diagnosis of "uveitis" plus "glaucoma" were compared with 4600 eyes with "POAG" only. Minimum inclusion criteria was ≥4 visits within a 4-year window. Relative risk (RR) of being a "rapid progressor" (mean deviation (MD) loss ≥1.5 dB/year) was calculated. A mixed-effects model (MEM) and a pointwise VF progression analysis of pattern deviation was used to confirm differences between the groups. Longitudinal IOP mean, range and variability were compared with rate of VF progression. RESULTS: Median (IQR) baseline MD in the uveitis and POAG groups was -3.8 (-8.7, -1.5) dB and -3.1 (-6.6, -1.2) dB respectively. The uveitis and POAG groups had 23/205 (11%) and 331/4600 (7%) "rapidly progressing" eyes respectively. Age-adjusted RR for "rapid progression" in uveitic versus POAG eyes was 1.9 (95% CI:1.8-2.0). The MEM confirmed that uveitic eyes (-0.49 dB/year) showed higher rates of VF progression than the POAG group (-0.37 dB/year; p<0.01). IOP range and variability were higher in the "rapidly progressing" uveitic eyes. CONCLUSIONS: Our analysis suggests that VF loss occurs faster in glaucoma patients with uveitis than those without uveitis. The risk of progressing rapidly in glaucoma with uveitis is almost double than in those without uveitis. Early identification of "rapid progressors" may enable targeted intervention to preserve visual function in this high-risk group.
| Type: | Article |
|---|---|
| Title: | Evaluating the Impact of Uveitis on Visual Field Progression Using Large Scale Real-World Data |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajo.2019.06.004 |
| Publisher version: | https://doi.org/10.1016/j.ajo.2019.06.004 |
| Language: | English |
| Additional information: | © 2019 The Author(s). Published by Elsevier Inc. Under a Creative Commons license (https://creativecommons.org/licenses/by-nc-nd/4.0/). |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10077670 |
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