Document Detail


Is there any difference in target intraocular pressure for exfoliative glaucoma patients with cardiovascular disease history?
MedLine Citation:
PMID:  20544681     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate if patients with exfoliation glaucoma (XFG) with cardiovascular disease (CVD) require different target intraocular pressure (IOP) compared to patients with XFG with no CVD for long-term stability.
METHODS: A retrospective, multicenter, observational cohort analysis included consecutive patients with XFG from 9 European academic centers, with a minimum of 5 years follow-up.
RESULTS: In 201 patients, there was a statistical difference between progressed and non-progressed patients in mean (p=0.0049) and peak (p=0.015) IOP, variance of IOP (p=0.028), and number of medicine changes/year (p=0.0037). At a mean IOP ≥22 mmHg, patients progressed in 84% (32/38), between 14 and 21 mmHg in 54% (81/151), and at ≤13 mmHg in 33% (4/12). There was no difference in the rate of progression between groups based on CVD history (p=0.65). However, IOP that allowed ≤50% progression rate for patients with mild or no CVD was ≤20-21 mmHg and ≤18 mmHg for patients with severe disease. Further, at IOP ≥20 mmHg, 8% (1/12) of patients with severe CVD remained stable in contrast to 38% (16/42) of patients with mild and 21% (4/19) with no CVD history (p=0.0093). By multivariant regression analysis of the IOP and CVD measures, mean IOP was a risk factor for progression (p=0.0097).
CONCLUSIONS: Although IOP is the main determinant of progression in XFG under treatment, history of severe CVD should be further investigated as potential risk factor for glaucomatous progression.
Authors:
Gábor Holló; Barbara Cvenkel; Miguel A Teus; Murat T Irkec; Yuri S Astakhov; Dorin Chiselita; Nataliya Petkova; Ivana Liehneová; Bartlomiej J Kaluzny; Péter Kóthy; Banu Bozkurt; Evgeny L Akopov; Jeanette A Stewart; Michael S Kristoffersen; Caroline J Kristoffersen; William C Stewart
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  European journal of ophthalmology     Volume:  20     ISSN:  1724-6016     ISO Abbreviation:  Eur J Ophthalmol     Publication Date:    2010 Nov-Dec
Date Detail:
Created Date:  2010-10-18     Completed Date:  2010-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9110772     Medline TA:  Eur J Ophthalmol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  1000-6     Citation Subset:  IM    
Affiliation:
Semmelweis University, Budapest, Hungary.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / administration & dosage
Cardiovascular Diseases / complications,  drug therapy,  physiopathology*
Cohort Studies
Disease Progression
Exfoliation Syndrome / complications,  drug therapy,  physiopathology*
Female
Follow-Up Studies
Glaucoma, Open-Angle / complications,  drug therapy,  physiopathology*
Humans
Intraocular Pressure / drug effects,  physiology*
Male
Retrospective Studies
Risk Factors
Tonometry, Ocular
Visual Acuity / physiology
Visual Fields / physiology
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

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