Baseline central field pattern predicts which glaucoma eyes progress

Design

Retrospective multicentre longitudinal cohort, over 10 years

Population

127 eyes of 94 adults with glaucoma and baseline central visual field defects

Primary outcome

Long-term central (10-2) visual field progression

Effect

Inferior defects hazard ratio 3.27 (2.67 to 3.99); both-hemifield 3.71 (3.02 to 4.57)

Knowing which glaucoma eyes will lose central vision helps target surveillance and treatment. This multicentre study followed 127 eyes of 94 adults with glaucoma and baseline central (10-2) visual field defects for more than 10 years, asking whether the baseline defect pattern predicted later central progression.

Over a mean 12.7 years, 42% of eyes progressed. Inferior defects and both-hemifield involvement were far more common in progressing eyes (54.7% vs 16.2% and 41.5% vs 4.1%). In adjusted models, inferior defects carried a hazard ratio of 3.27 (95% CI 2.67 to 3.99) and both-hemifield defects 3.71 (3.02 to 4.57) for progression, as did specific inferonasal and nasal archetypal patterns.

The practical use is risk stratification: an eye with baseline inferior or both-hemifield central defects warrants closer 10-2 monitoring and a lower threshold to escalate treatment. The data are retrospective, so the pattern flags higher risk rather than dictating management on its own.

• Multicentre study of 127 eyes with baseline central (10-2) defects, followed over 10 years.
• 42% of eyes progressed over a mean 12.7 years.
• Inferior defects: hazard ratio 3.27 (95% CI 2.67 to 3.99) for central progression.
• Both-hemifield defects: hazard ratio 3.71 (3.02 to 4.57).
• Monitor eyes with baseline inferior or both-hemifield central defects more closely.

Why it matters

It turns the baseline central field, already obtained, into a prognostic tool for who will lose central vision, where surveillance matters most.

Don't overread it

This was retrospective; the patterns predict progression risk but do not themselves establish how aggressively to treat.

The statistics, in plain English

Hazard ratios above 3 with intervals well clear of 1.0 indicate a strong association; as a retrospective cohort it identifies higher-risk patterns rather than proving that acting on them changes outcomes.

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