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Brain Infarct Increases Risk of Visual Field Loss in Glaucoma

Last Updated: July 06, 2009.

Silent cerebral infarct increases the risk for visual field progression in patients with normal-tension glaucoma, according to a study reported in the July issue of Ophthalmology.

MONDAY, July 6 (HealthDay News) -- Silent cerebral infarct (SCI) increases the risk for visual field progression in patients with normal-tension glaucoma, according to a study reported in the July issue of Ophthalmology.

Dexter Y.L. Leung, of the Chinese University of Hong Kong, and colleagues recruited 286 Chinese patients with newly diagnosed normal-tension glaucoma, including 64 patients with SCI, as detected by cranial computed tomography scan (mean age, 72.4), and 222 patients without SCI (mean age, 63.2). The patients were followed up for 36 months at four-month intervals to check for visual field progression. The primary study outcome was the association between SCI and visual field progression.

The researchers found that 65.6 percent of those with SCI had visual field progression, compared to 45.9 percent of those without SCI. Cox proportional hazards regression analysis found that factors significantly associated with visual field progression included disc hemorrhage (hazard ratio, 2.28), SCI (hazard ratio, 1.61), systemic hypertension (hazard ratio, 1.48), and central corneal thickness (hazard ratio, 1.35).

"The present study demonstrated a statistical as well as a temporal association between SCI and visual field progression in normal-tension glaucoma patients. Further evidence on the prognostic significance of SCI would be provided if one could also demonstrate a dose-response relationship," the authors write. "It also would be invaluable if future interventional studies could assess whether preventing SCI may slow or even halt visual field progression in these patients. Further studies on the role of SCI in other forms of glaucoma will be of interest."

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