Risk factors for blindness in patients with open-angle glaucoma followed-up for at least 15 years

Arquivos Brasileiros de Oftalmologia

Jayter Silva Paula¹  João Marcello Furtado¹  Arles Silva Santos¹  Roberto De Mattos Coelho¹  Eduardo Melani Rocha¹  Maria De Lourdes Veronese Rodrigues¹ 

[1] ,Universidade de São Paulo School of Medicine of Ribeirão Preto Department of Ophthalmology, Otorhinolaryngology, and Head and Neck SurgeryRibeirão Preto SP ,Brazil

关键词: Glaucoma;    open-angle;    Blindness;    Optic disk;    Glaucoma;    open-angle;    Visual acuity;    Risk Factors;    Glaucoma de ângulo aberto;    Cegueira;    Disco óptico;    Glaucoma de ângulo aberto;    Acuidade visual;    Fatores de risco;   

DOI  :  10.1590/S0004-27492012000400004

来源: SciELO

【 摘 要 】

PURPOSE: To determine the proportion of blindness and investigate the relationships between risk factors based on clinical characteristics and development of blindness in patients with primary open-angle glaucoma (POAG) treated for at least 15 years. METHODS: A retrospective observational chart review was performed with 403 patients referred to a tertiary level hospital, each with a diagnosis of primary open-angle glaucoma, treated for at least 15 years. Blindness attributable to glaucoma was defined based on visual acuity and/or visual field tests. Variables considered to be possible risk factors for blindness were evaluated using odds ratio (OR), confidence interval (95% CI), and univariate and multivariate analyses. RESULTS: Thirty-one patients became blind [13/53 (24.5%) - unilaterally and 18/53 (34%) - bilaterally] during the follow-up period of treatment (19.5 ± 4.6 years, range 15-31 years). Multivariate statistics with regression analysis revealed that persistency on initial therapy ≤6 months was significantly associated with blindness, both unilateral (OR: 8.4; 95% CI: 1.3-56.4) and bilateral (OR: 7.2; 95% CI: 1.3-39.6). Other potential factors such as race, age, gender or number of medications were not associated with blindness. CONCLUSION: Blindness from primary open-angle glaucoma was not uncommon in this population of treated patients after the long follow-up period proposed. Persistence rates with the first therapy, as measured by a medical decision to change, were low. Persistence ≤6 months was statistically associated with the development of unilateral and bilateral blindness from glaucoma.

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