Purpose: To determine the mortality within ten years of diagnosis of chronic open angle glaucoma and the visual field progression amongst survivors of a group of patients who were followed for ten years.
Patients and methods: Of the 436 patients seen in a glaucoma case-finding clinic between July 1994 and December 1995 a diagnosis of chronic open angle glaucoma was made in 65. Ten years after diagnosis the outcome of the 57 patients who were treated at the Oxford Eye Hospital was determined. The causes of death were obtained from the General Practitioner records and from the official death certificates. The probability of death was analysed using a Kaplan-Meier survival curve. The visual field of each eye of survivors was graded using a nine-stage severity scale. The visual outcome was analysed at the ten-year follow up visit.
Findings: Seventeen patients (29.8%) died during the ten-year period, including nine from cardiovascular disease. The mean age at presentation of those that died was 76.4 years (±9.7) compared with 69.5 years (±10.9) for survivors (P=0.029). Using a nine-stage grading system, 42 eyes (52.5%) did not deteriorate, 30 eyes (37.5%) deteriorated by one stage, seven eyes (8.75%) two stages and one eye (1.25%) three stages over the ten-year period. The average time to first deterioration by one stage was 8.51 years (CI 7.92-9.10). The mean IOP was 25.6 mmHg (±5.8 mmHg) on presentation and 15.7 mmHg (±3.0 mmHg) at the end of ten years.
Conclusion: Approximately two thirds of patients will still be under care ten years after presentation. In elderly white patients with glaucoma the overall goal of preventing visual handicap is achievable for most patients ten years after diagnosis.
- Visual outcome