Montesano, Giovanni;
Ometto, Giovanni;
Ahmed, Iqbal Ike K;
Ramulu, Pradeep Y;
Chang, David F;
Crabb, David P;
Gazzard, Gus;
(2023)
Five-Year Visual Field Outcomes of the HORIZON Trial.
American Journal of Ophthalmology
, 251
(7)
pp. 143-155.
10.1016/j.ajo.2023.02.008.
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Abstract
PURPOSE: To compare visual field (VF) progression between glaucoma patients receiving cataract surgery alone (CS) or with a Hydrus microstent (CS-HMS). DESIGN: Post hoc analysis of VF data from the HORIZON multicenter randomized controlled trial. METHODS: A total of 556 patients with glaucoma and cataract were randomized 2:1 to either CS-HMS (369) or CS (187) and followed up for 5 years. VF was performed at 6 months and then every year after surgery. We analyzed data for all participants with at least 3 reliable VFs (false positives < 15%). Average between-group difference in rate of progression (RoP) was tested using a Bayesian mixed model and a 2-sided Bayesian P value <.05 (main outcome). A multivariable model measured the effect of intraocular pressure (IOP). A survival analysis compared the probability of global VF sensitivity dropping by predefined cutoffs (2.5, 3.5, 4.5, and 5.5 dB) from baseline. RESULTS: Data from 352 eyes in the CS-HMS arm and 165 in the CS arm were analyzed (2966 VFs). The mean RoP was -0.26 dB/y (95% credible interval -0.36, -0.16) for CS-HMS and -0.49 dB/y (95% credible interval -0.63, -0.34) for CS. This difference was significant (P = .0138). The difference in IOP only explained 17% of the effect (P < .0001). Five-year survival analysis showed an increased probability of VF worsening by 5.5 dB (P = .0170), indicating a greater proportion of fast progressors in the CS arm. CONCLUSIONS: CS-HMS has a significant effect on VF preservation in glaucoma patients compared with CS alone, reducing the proportion of fast progressors.
| Type: | Article |
|---|---|
| Title: | Five-Year Visual Field Outcomes of the HORIZON Trial |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.ajo.2023.02.008 |
| Publisher version: | https://doi.org/10.1016/j.ajo.2023.02.008 |
| Language: | English |
| Additional information: | © 2023 THE AUTHOR(S). PUBLISHED BY ELSEVIER INC. THIS IS AN OPEN ACCESS ARTICLE UNDER THE CC BY LICENSE (HTTP://CREATIVECOMMONS.ORG/LICENSES/BY/4.0/) |
| Keywords: | CLINICAL-TRIALS, CONTRAST SENSITIVITY, INTRAOCULAR-PRESSURE, Life Sciences & Biomedicine, NEUROPROTECTION TRIALS, OCULAR HYPERTENSION, OPEN-ANGLE GLAUCOMA, Ophthalmology, PROGRESSION, QUALITY-OF-LIFE, RANDOMIZED-TRIAL, SCHLEMMS CANAL MICROSTENT, Science & Technology |
| 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/10171949 |
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