Positive family history increases likelihood of visual field loss at presentation

Patients with a positive family history of glaucoma are 10 times as likely to have visual field (VF) defects at the time of their diagnosis, according to a study published in the April issue of Clinical & Experimental Ophthalmology, the official Journal of the Royal Australian and New Zealand College of Ophthalmologists.

Narme C. Deva MBChB of the Department of Ophthalmology, University of Auckland, New Zealand and colleagues conducted the case-control study of 107 newly diagnosed glaucoma patients to identify risk factors associated with VF loss on first presentation of glaucoma. VF grading included classifications for nasal step, paracentral scotoma and/or arcuate scotoma.

Thirty seven percent of patients had a positive family history. Mean patient age was 59 years; mean IOP, 21.4 mmHg; mean cup:disc ratio, 0.69. The mean age of patients presenting without VF defects was 54 years, compared with a mean age of 63 years for patients presenting with mild to severe VF defects. At presentation, 29% of patients scored ≥6 on the Advanced Glaucoma Intervention Study (AGIS) scale. Multivariate logistic regression analysis identified independent risk factors for VF loss at presentation: positive family history (odds ratio, 10.43) and age (odds ratio, 1.15).

The researchers concluded that, as a positive family history is associated with a ten times increased risk of VF defect at presentation, early identification of these higher-risk patients could prevent extensive VF loss.