Rate of visual field loss in progressive glaucoma

Objective: To investigate the rate of visual field (VF) loss in progressive glaucoma. Setting: Outpatient department, nonreferral base. Methods: A cohort of 34 patients with normal-pressure glaucoma (NPG), 68 pa tients with primary open-angle glaucoma (POAG), and 125 patients with ocula r hypertension (OHT) were followed up for an average of 9 years. Visual fie lds were obtained annually with automated perimetry. The rate of VF loss as a percentage per year was calculated. Results: Twenty-three eyes with NPG, 31 with POAG, and 10 with OHT showed p rogression of VF loss. The mean (+/-SD) rates of VF deterioration were 3.7% +/- 3.3% per year in NPG, 2.5% +/- 1.8% in POAG, and 2.3% +/- 1.3% in OHT converting to POAG, and did not differ significantly. No difference in the rate of VF loss was found between eyes with and without optic disc hemorrha ges (2.7% +/- 2.9% and 3.1% +/- 2.1%, respectively). The rate of VF loss wa s not related to the initial VF status. The rate of VF loss between the sup erior and inferior hemifields was correlated in patients with NPG (r(s) = 0 .67, P = .04). Comparison of visual field loss with linear regression analy sis showed significant slopes in only 37.5% of eyes with progression, which had a progression rate of 4.2% +/- 3.0%. Conclusions: The rate of VF loss did not differ between patients with NPG a nd POAG. The rate of deterioration was related neither to initial VF status nor to the presence of disc hemorrhages. Linear regression is applicable o nly in a portion of the patients who have progression of VF loss.