Résumé
Purpose: to test the hypothesis that vitreofoveal separation (VS) increases the visual field (VF) progression in glaucoma.Design: retrospective cohort study.Patients: we enrolled eyes of patients between 18 and 85 years of age with at least five VFs, 4 years of follow-up, and without vitrectomy. A total of 384 eyes of 227 patients were included.Methods: fourier-domain optical coherence tomography was used to investigate if patients with glaucoma have VS. Patients were classified with VS or without. VF progression was determined by Glaucoma Progression Analysis II.Main outcome measures: VF progression, visual field index (VFI) rate, and retinal nerve fiber layer (RNFL) rate.Results: a total of 253 eyes had VS while 131 eyes did not. The follow-up duration was 7 years for both groups. VF progression was detected in 64 (25.3%) eyes with VS and 25 (19.1%) eyes without VS (p=0.12). The VFI rate was -0.85%/year for eyes with VS and -0.60%/year for eyes without VS, (p=0.18), and RNFL rate was -0.84 µm/year for eyes with VS and -0.98 µm/year for eyes without VS (p=0.82). The relative risk of VF progression with VS was 1.33. Twenty-two patients had two eyes with different VS status, five (22.73%) patients had only VF progression in the eye with VS, one (4.55%) patient had progression in the two eyes, and none of the patients had progression only in the eye without VS.For primary open-angle glaucoma (POAG), the VS group seemed to have more VF progression because there was a significant difference in the VFI rate (p=0.03), the 35 final mean deviation (p=0.02), and the difference in MD (p=0.01), but the progressionrate was not significantly different (p=0.10). The relative risk of progression of PAOG with VS was 1.55.Conclusions: we did not find a link between VS and VF progression in patients with glaucoma. However, for POAG, VF progression can increase with VS. Other studies are needed to confirm these results, especially prospective studies with high power.