Open-angle glaucoma patients who are older, have higher peak intraocular pressure (IOP) and the pseudoexfoliative form of the disease may be more prone to faster rates of visual field loss, a study from the Jules Stein Eye Institute reports.

The study, published in the American Journal of Ophthalmology, also found baseline mean deviation was associated with the rate of visual field worsening.

The cohort study enrolled 1,317 eyes of 745 open-angle glaucoma patients who were approximately 63 years old and had a median mean deviation of -2.4 (-0.7 to –5.6) dB at baseline. The patients had approximately 12 visual field tests over a period of about 11 years. The investigators used mean deviation, visual field index and glaucoma rate index rates to measure the visual field decay.

Researchers found older age, higher peak IOP, pseudoexfoliative glaucoma and a history of glaucoma surgery during the study period were all tied to faster rates of progression, regardless of the method used to measure the deterioration.

Additionally, higher peak IOP was a significant predictor of fast progression, the study noted. 

Being able to identify and aggressively treat fast progressors would reduce visual disability in glaucoma, researchers said.

Kim JH, Rabiolo A, Morales E, et al. Risk factors for fast visual field progression in glaucoma. Am J Ophthalmol. June 22, 2019. [Epub ahead of print].