Continued Visual Field Progression in Eyes With Prior Visual Field Progression in Patients With Open-Angle Glaucoma

Purpose: To evaluate continued visual field (VF) progression in eyes with prior VF progression from open-angle glaucoma, using event-based criteria. Methods: Retrospective observational case series of 70 eyes (70 patients) with open-angle glaucoma, treated for at least 2 years, that had earlier shown 1 step of VF progression. Further VF progression required a worsening of 3 adjacent points at the same location on 2 consecutive VF tests. Potential risk factors for continued progression were evaluated. Results: The mean follow-up was 127 +/- 43 months. Thirty-seven eyes (55%) continued to progress. At 5, 10, and 15 years after the initial VF, the Kaplan-Meier estimate of the risk of developing 2 steps of progression was 18%, 53%, and 71%. A shorter time to the first step of progression was significantly associated with further progression (P < 0.001), as was slope of the VF mean deviation (P < 0.001) and pattern standard deviation (P = 0.041). Eyes with further progression had higher mean IOP after the first step of progression (P = 0.026). Among 37 eyes with 2 steps of progression, the estimate of the risk of progressing further was 32% at 10 years after the initial VF. Conclusion: Eyes with a relatively shorter time to initial VF progression from open-angle glaucoma are likely to continue to progress over long-term follow-up. More aggressive treatment in such eyes might reduce the likelihood of further VF progression.