Screening for vascular risk factors in glaucoma: the GVRF study.

PURPOSE: To determine the prevalence of vascular risk factors (VRF) in patients with primary open-angle glaucoma (POAG), normal tension glaucoma (NTG), and ocular hypertension (OH), and to evaluate their influence in the progression of the disease.

METHODS

269 Belgian ophthalmologists were invited to participate in this cross-sectional prevalence study. Using a questionnaire the following parameters were analyzed in patients with POAG, NTG, and OH: age, intraocular pressure, refraction, visual field defect, vertical cup/disc ratio, medical therapy, and vascular risk factors. Progression of visual field was based on subjective analysis of minimum three reliable automated perimetries over a period of minimum three years.

RESULTS

4920 patients were enrolled in the study. 75% had POAG, 8% had NTG, and 17% had OH. The mean age was 67 years (40-99 y.). Fifty-three percent were female. There was a significant difference in the prevalence of no VRF vs. >1 VRF between the patients with OH and the patients with POAG/NTG (p < 0.01). Visual field progression was found in 34% of the patients with POAG and 46% of the patients with NTG. In the group with POAG the presence of at least 2 and at least 3 VRF increased the risk for visual field progression with respectively 16% and 42% compared to patients without VRF (p = respectively 0.03 and 0.002).

CONCLUSIONS

The prevalence of VRF is significantly higher in patients with POAG/NTG compared to patients with OH. The presence of VRF might increase the risk for progression of glaucomatous visual field defects.