Document Detail


Characteristics of visual field progression in medically treated normal-tension glaucoma patients with unstable ocular perfusion pressure.
MedLine Citation:
PMID:  20861474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate the characteristics of visual field (VF) progression in medically treated normal-tension glaucoma (NTG) patients (Koreans) with unstable ocular perfusion pressure (OPP).
METHODS: One hundred one eyes of 101 NTG patients followed up for more than 4 years (mean follow-up, 6.2 years ± 12.1 months) were included. Modified Anderson criteria (MC) and linear regression analysis (LA) of VF mean deviation (MD) within the central 10° and 10° to 24° area were assessed for determining VF progression in groups with lowest (LMF) and highest (HMF) 24-hour mean OPP [MOPP = 2/3;(mean arterial pressure - IOP)] fluctuation. Kaplan-Meier analyses were used to compare the elapsed time of confirmed VF progression in the two groups. Hazard ratios (HRs) for the association between clinical risk factors including 24-hour MOPP and central VF progression were obtained by using Cox proportional hazards models.
RESULTS: Three of 33 eyes in the LMF progressed, whereas 12 of 34 eyes in the HMF progressed within the central 10° according to the MC; the between-group difference was significant (P = 0.010). By LA within the central 10°, two eyes from the LMF and nine from the HMF groups showed progression (P = 0.025). The HMF showed a greater cumulative probability of central VF progression than the LMF, by both LA and MC (Kaplan-Meier analysis, P = 0.003, 0.015, log-rank test). In multivariate analysis, only 24-hour MOPP fluctuation was significantly associated with central VF progression (P = 0.014).
CONCLUSIONS: The 24-hour MOPP fluctuation was the most consistent prognostic factor among various IOP, blood pressure, and clinical factors for central VF glaucomatous progression in our series of NTG eyes.
Authors:
Kyung Rim Sung; Jung Woo Cho; Suhwan Lee; Sung-Cheol Yun; Jaewan Choi; Jung Hwa Na; Youngrok Lee; Michael Scott Kook
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Publication Detail:
Type:  Journal Article     Date:  2011-02-09
Journal Detail:
Title:  Investigative ophthalmology & visual science     Volume:  52     ISSN:  1552-5783     ISO Abbreviation:  Invest. Ophthalmol. Vis. Sci.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-10     Completed Date:  2011-04-01     Revised Date:  2013-01-09    
Medline Journal Info:
Nlm Unique ID:  7703701     Medline TA:  Invest Ophthalmol Vis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  737-43     Citation Subset:  IM    
Affiliation:
Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Songpa-gu, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / therapeutic use
Blood Pressure / physiology
Disease Progression
Drug Combinations
Female
Follow-Up Studies
Gonioscopy
Humans
Intraocular Pressure / physiology*
Low Tension Glaucoma / diagnosis,  drug therapy*,  physiopathology*
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Tonometry, Ocular
Vision Disorders / physiopathology*
Visual Fields / physiology*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Drug Combinations

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