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Purpose To compare rim area rates in patients with and without the visual field (VF) progression endpoint in the Canadian Glaucoma Study and determine whether intraocular pressure (IOP) reduction following the endpoint altered rim area rate. Design Prospective multicenter cohort study. Methods setting: University hospitals. patient population: Two hundred and six patients with open-angle glaucoma were examined at 4-month intervals with standard automated perimetry and confocal scanning laser tomography. intervention: After the endpoint, IOP was reduced by ≥20%. outcome measures: Univariate analysis for change in rim area rate and multivariable analysis to adjust for independent covariates (eg, age, sex, and IOP). Results Patients with an endpoint (n = 59) had a worse rim area rate prior to the endpoint compared to those without (n = 147; median [interquartile range]: −14 [−32, 11] × 10 −3 mm 2 /y and −5 [−14, 5] × 10 −3 mm 2 /y, respectively, P = .02). In univariate analysis, there was no difference in rim area rate before and after the endpoint (median difference [95% CI], 8 (−10, 24) × 10 −3 mm 2 /y), but the muItivariate analysis showed that IOP reduction >2 mm Hg after the endpoint was strongly linked to a reduction in rim area rate decline (8 × 10 −3 mm 2 /y for each additional 1 mm Hg reduction). Conclusions Patients with a VF endpoint had a median rim area rate that was nearly 3 times worse than those without an endpoint. Lower mean follow-up IOP was independently associated with a slower decline in rim area.

We determined the static visual thresholds within 15 degrees of fixation of 36 patients with elevated intraocular pressures but normal visual fields and compared the result with 36 controls matched for age and sex. We found no difference in the mean threshold level between the two groups. We did find a tendency for the patients with elevated IOPs to have greater variability or scatter of their threshold responses close to fixation. We also found the patients had larger cup to disc ratios than the controls.

• The epinephrine pressure reduction was determined in 32 patients with elevated intraocular pressure (IOP) and 18 patients with untreated chronic open-angle glaucoma. The prevalence of responders was 53% of those patients with elevated IOP and 56% in those patients with open-angle glaucoma. This lack of difference between the two groups is suggestive of the need for caution before applying epinephrine in clinical practice as a predictive factor of future field loss.