Progression of visual field loss in untreated glaucoma patients and suspects in St Lucia, West Indies.

PURPOSE A 1986-1987 survey found an 8.8% prevalence of open-angle glaucoma in the black population of St Lucia, West Indies. This follow-up study assessed progression of visual field loss in untreated glaucoma patients and persons with suspected glaucoma 10 years later. METHODS Subjects were 205 patients with or suspected of having glaucoma. The 1987 data included age, sex, visual acuity, and visual fields measured by automated threshold perimetry (Humphrey C-30-2 test). The 1997 data included intraocular pressure, visual acuity, and visual fields measured by the same test. Exclusion criteria included field unreliability, field improvement due to vision improvement, nonglaucomatous vision deterioration, glaucoma treatment since 1988, and scoring of a field as end-stage in 1987. Visual fields were scored by algorithms for the Advanced Glaucoma Intervention Study (AGIS) and Collaborative Initial Glaucoma Treatment Study (CIGTS). RESULTS By AGIS criteria, 55% of 146 right eyes and 52% of 141 left eyes progressed. In linear regressions, progression severity was unassociated with male or female sex, intraocular pressure, or baseline visual field score, but was positively associated with age (P < .001, right; P = .002, left). By CIGTS criteria, more eyes progressed. The cumulative probability of reaching end-stage disease in 10 years in at least on eye was about 16% by AGIS criteria and was 35% by CIGTS criteria. CONCLUSIONS These data provide a unique opportunity to study progression of untreated glaucoma. A considerably larger percentage of eyes showed progression of visual field loss, and the rate of progression was greater than in studies of visual field loss in treated eyes.