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Risk Factors for Glaucoma Visual Field Changes Identified

Abnormal anticardiolipin antibody levels, increasing age tied to faster change; treatment can slow decline

TUESDAY, Aug. 10 (HealthDay News) -- Visual field change in glaucoma occurs faster in patients with abnormal anticardiolipin antibody levels and higher age, but the change can be slowed with modest reductions in intraocular pressure (IOP), according to research published online Aug. 9 in the Archives of Ophthalmology.

Balwantray C. Chauhan, Ph.D., of Dalhousie University in Halifax, Canada, and colleagues monitored 216 glaucoma patients from the Canadian Glaucoma Study every four months for visual field changes. Patients who reached an end point had 20 percent or greater reductions in IOP achieved by a stepwise treatment protocol of monotherapy, adjunct topical therapy, argon laser trabeculoplasty, and/or systemic carbonic anhydrase inhibitors and trabeculectomy.

The researchers found that abnormal anticardiolipin antibody levels were associated with a significantly worse visual field mean deviation (MD) rate of change compared with normal anticardiolipin antibody levels. Increasing age also was associated with a worsened MD rate; however, female sex and mean follow-up IOP were not. After patients achieved the first end point, the median IOP decreased from 18.0 to 14.8 mm Hg, with an accompanying significant decrease in MD rate change from −0.36 to −0.11 dB/y.

"Patients with abnormal anticardiolipin antibody levels and increasing age had faster visual field change. Modest IOP reduction in progressing patients significantly ameliorated the rate of visual field decline," the authors write.

The study was supported in part by unrestricted grants from Allergan Canada, Merck Frosst Canada, and Pfizer Canada.

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