Changes in axial length and progression of visual field damage in glaucoma

Abstract

PURPOSE. To investigate the relationship between axial length (AL) elongation and progression of primary open-angle glaucoma (POAG). METHODS. AL was measured twice over a 5.1 ± 0.76 (mean 6 standard deviation: SD) year period in 125 eyes of 72 patients with POAG. The eyes were divided into not long (AL < 26 mm, 80 eyes) and long (>26 mm, 45 eyes) groups. During this period, patients’ visual fields (VFs) were measured with the Humphrey Field Analyzer 12.4 ± 7.5 times and intraocular pressure (IOP) was measured with Goldmann applanation tonometry 27.0 ± 7.5 times. The relationship between the mean total deviation (mTD) progression rates in the whole field and superior and inferior hemifield, as well as in 10 VF sectors, and the variables of age, mean IOP, SD of IOP, AL, difference in AL (ΔAL), and mTD value at baseline was examined. RESULTS. There was a significant difference between AL at baseline and AL at repeat measurement (P < 0.0001). ΔAL was 0.035 ± 0.10 mm. An increase in ΔAL was significantly related to AL at baseline (P = 0.027), but not to age, mean IOP, and SD of IOP. ΔAL was related to the progression of mTD in the inferior hemifield (slower mTD progression was associated with increased ΔAL), but not in the whole field or superior hemifield. Increased ΔAL was related to slower progression rates in 2 of 10 sectors, both in the inferior hemifield. CONCLUSIONS. The main finding was that an increase in AL was significantly related to slower VF progression in the inferior hemifield.