Original articleThe Advanced Glaucoma Intervention Study (AGIS): 12. Baseline risk factors for sustained loss of visual field and visual acuity in patients with advanced glaucoma☆
Section snippets
Design
The AGIS design and methods have been described in detail elsewhere2, 3, 4 and are summarized here. From April 1988 through November 1992, investigators at eleven AGIS clinical centers enrolled a total of 789 eyes of 591 patients. Eligible eyes were randomized to one of two intervention sequences: argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) or trabeculectomy-ALT-trabeculectomy (TAT). The first intervention was administered soon after enrollment; the second and third
Methods
To be eligible for AGIS, patients had to be 35 to 80 years old and eligible eyes had to be phakic and have either (1) advanced primary open-angle glaucoma without previous glaucoma surgery or (2) residual open-angle glaucoma (without any peripheral anterior synechia) 4 or more weeks after laser iridotomy. We considered glaucoma in an eye to be advanced when, in the presence of at least some glaucomatous visual field loss, the disease could not be adequately controlled by medications alone. Eyes
Results
Table 1 presents either the relative frequencies or means of the baseline characteristics (listed in Table 2) considered in these analyses. The average baseline visual field defect score was 8.4, and the average baseline BCVA score was 79.5 letters (about 20/25). All eyes had at least one AGIS intervention, 28% (208/747) had at least two, and 5% (39/747) had three or more. More details on intervention failure and risk factors for intervention failure are provided in AGIS Report 11.1 Although
Discussion
This study was undertaken to explore baseline risk factors for vision loss in eyes of patients with advanced glaucoma rather than to test specific existing hypotheses. Analyses were conducted within each treatment sequence, because we did not assume that the risk factors would be the same for both sequences. Further, the statistical significance of risk factors may depend on specific duration of follow-up.
In both the ATT sequence and the TAT sequence, an increased risk of SDVF is associated
References (43)
- et al.
Intraocular pressure and the rate of visual field loss in chronic open-angle glaucoma
Am J Ophthalmol
(1991) - et al.
Visual field progression in patients with initially unilateral visual field loss from chronic open-angle glaucoma
Ophthalmology
(2000) - et al.
Intraocular pressure and progression of glaucomatous visual field loss
Am J Ophthalmol
(2000) - et al.
Factors contributing to the progression of visual field damage in eyes with normal-tension glaucoma
Ophthalmology
(1994) - et al.
Estimating progression of visual field loss in glaucoma
Ophthalmology
(1997) - et al.
Rate of visual field loss and long-term visual outcome in primary open-angle glaucoma
Am J Ophthalmol
(2001) - et al.
Intraocular pressure and visual field defects after argon laser trabeculoplasty in chronic open-angle glaucoma
Ophthalmology
(1987) - et al.
Factors associated with long-term progression or stability in primary open-angle glaucoma
Am J Opthalmol
(2000) - et al.
Correlation between intraocular pressure control and progressive glaucomatous damage in primary open-angle glaucoma
Am J Ophthalmol
(1991) - et al.
Risk factors for progression of visual field abnormalities in normal-tension glaucoma
Am J Ophthalmol
(2001)
The probability of blindness from open-angle glaucoma
Ophthalmology
Otago glaucoma surgery outcome studylong-term results of trabeculectomy—1976 to 1995
Opthalmology
Standardizing diagnostic procedures
Am J Ophthalmol
The Advanced Glaucoma Intervention Study (AGIS):11. Risk factors for failure of trabeculectomy and argon laser trabeculoplasty in advanced glaucoma patients
Am J Ophthalmol
Advanced Glaucoma Intervention Study (AGIS) Manual of Operations
The Advanced Glaucoma Intervention Study (AGIS):1. Study design and methods and baseline characteristics of study patients
Control Clin Trials
The Advanced Glaucoma Intervention Study (AGIS):2. Visual field test scoring and reliability
Ophthalmology
Early Treatment Diabetic Retinopathy Study design and baseline patient characteristicsETDRS Report Number 7
Ophthalmology
Cox-type regression analysis for large numbers of small groups of correlated failure time observations
Long-term outcome following trabeculectomyII Visual field survival
Acta Ophthalmol (Copenh)
The visual field after trabeculectomy. A follow-up study using computerized perimetry
Acta Ophthalmol
Cited by (190)
Visual Field Endpoints for Neuroprotective Trials: A Case for AI-Driven Patient Enrichment
2022, American Journal of OphthalmologyBaseline Vessel Density Parameters for Predicting Visual Field Progression in Open-Angle Glaucoma Eyes With Central Visual Field Damage
2022, American Journal of Ophthalmology
- ☆
This study was supported by grants from the National Eye Institute and the Office of Research on Minority Health (grant numbers U10 EY06824 through U10 EY06827, U10 EY06830 through U10 EY06835, U10 EY07057, and U10 EY09640). The two agencies are part of the National Institutes of Health, U.S. Department of Health and Human Services.
- ∗
The writing team members for this paper are: Beth Blackwell, ScD, Douglas Gaasterland, MD, Fred Ederer, MA, FACE, Leonard G. Dally, MSc, Paul Van Veldhuisen, MS, Bruce E. Prum, MD, Marshall Cyrlin, MD, L. Jay Katz, MD, Howard Weiss, MD, Paul Lichter, MD, and Jacob Wilensky, MD.
(A complete list of staff in the Advanced Glaucoma Intervention Study appears at the end of AGIS Report 11 [AJO 2002;134:481–498]).