Visual field progression in patients with initially unilateral visual field loss from chronic open-angle glaucoma

Purpose: To investigate visual field progression in patients with initially unilateral glaucomatous visual field loss, and to determine risk factors f or progression. Design: Retrospective observational case series. Participants: Forty-eight consecutive patients with primary open-angle glau coma, pseudoexfoliative glaucoma, or pigmentary glaucoma, seen over an 18-m onth period, who initially had unilateral visual field loss as defined by u se of modified Anderson criteria. Patients were followed with standard Hump hrey perimetry for a minimum of 2 years. Methods: Progression was defined by use of modified Anderson criteria, and Advanced Glaucoma Intervention Study (AGIS) and Collaborative Initial Glauc oma Treatment Study scores. Main Outcome Measure: Visual field progression. Results: Three patients (6.2%) had fellow eye progression over a mean follo w-up of 76 months and duration of disease of 8.7 years. Fellow eye progress ion correlated with progression of the first-affected eye (P = 0.044). Ten patients (21%) had progression of the first-affected eye; these eyes had a larger initial cup/disc ratio compared with stable eyes (P = 0.041). increa sing initial AGIS score was associated with progression (P = 0.003). Kaplan -Meier survival analysis estimated the risk of progression at 5 years to be 25% in first-affected eyes and 7.2% in fellow eyes. Conclusions: In this population, the risk of fellow eye progression in pati ents with initially unilateral visual field loss from open-angle glaucoma i s low. Progression is higher in eyes with visual field loss at initial test ing, and the risk of progression increases as the level of initial visual f ield loss increases. Ophthalmology 2000;107. 1688-1692 (C) 2000 by the Amer ican Academy of Ophthalmology.