Recurrent visual field progression happens for 1 in 4 with glaucoma, study finds

03 Nov 2026, 22:40 · Medical Xpress

by Lori Solomon

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Recurrent visual field progression after a first guided progression analysis (GPA) progression event is common, according to a study published online Oct. 22 in JAMA Ophthalmology.

Davina A. Malek, M.D., from the Bascom Palmer Eye Institute in Miami, and colleagues evaluated the incidence of recurrent visual field progression after an initial GPA likely-progression event. The analysis included 635 eyes from patients with open-angle glaucoma or suspected glaucoma with adequate follow-up after first progression and intraocular pressure (IOP) data.

The researchers found that during a mean 12.4 years of follow-up, 26.3% had recurrence, with Kaplan-Meier cumulative recurrence of 13.8% at three years and 43.5% at 10 years. Faster mean deviation (MD) loss before first progression (hazard ratio [HR], 1.73 per 1 decibel [dB]/year), higher mean IOP after the first event (HR, 1.09 per 1 mm Hg), less negative MD at first progression (HR, 1.08 per 1 dB), and older age (HR, 1.11 per five years) were independently associated with recurrence.

A lower risk was seen for each 10% greater IOP reduction (HR, 0.89). For eyes with pre-event MD slopes faster than −1.0 dB/year, recurrence occurred in 42.7% of eyes versus 23.4% in slower-progressing eyes.

"These results may help target intensified monitoring and IOP lowering toward higher-risk eyes," the authors write.

Several authors disclosed ties to the health technology or pharmaceutical industries.

Publication details

Davina A. Malek et al., Incidence and Risk Factors of Recurrent Visual Field Progression in Glaucoma, JAMA Ophthalmology (2026). DOI: 10.1001/jamaophthalmol.2026.4609

Journal information: JAMA Ophthalmology

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