Abstract
Purpose
To determine the incidence of glaucomatous progression at mean intraocular pressure (IOP) levels in patients with ocular hypertension (OHT).
Methods
A retrospective, multicentre, cohort analysis of 230 OHT patients with 5 years of follow-up evaluated for risk factors associated with progressive optic disc and visual field loss to determine the incidence of glaucomatous progression.
Results
Forty percent of patients with IOPs ⩾24 mmHg, 18% of patients with IOPs of 21–23 mmHg, 11% of patients with IOPs with 18–20 mmHg, and 3% of patients with IOPs of ⩽17 mmHg progressed to glaucoma. The mean IOP was 19.8±2.4 mmHg in the stable group and 21.7±2.6 mmHg in the progressed group (P=0.0004). The highest average peak IOP was 23.4±4.0 mmHg in the stable group and 25.2±3.1 mmHg in the progressed group (P=0.006). Based on the pachymetry values for central corneal thickness, patients with thinner corneas more often progressed to glaucoma (P<0.0001). A multivariant regression analysis to determine risk factors for progression was positive primarily for higher peak IOPs, older age, male gender, argon laser trabeculoplasty, visual acuity ⩾20/50, and no topical medical therapy or β-blocker therapy prior to the study.
Conclusions
IOP reduction within the normal range over 5 years of follow-up reduces the chance of progression to primary open-angle glaucoma in OHT patients.
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References
Brandt JD, Beiser JA, Kass MA, Gordon MO . Central corneal thickness in the ocular hypertension treatment study (OHTS). Ophthalmology 2001; 108: 1779–1788.
Book SA . Essentials of Statistics. McGraw-Hill Book Company:New York, 1978; 122: 205.
Stewart WC, Chorak RP, Hunt HH, Sethuraman G . Factors associated with visual loss in patients with advanced glaucomatous changes in the optic nerve head. Am J Ophthalmol 1993; 116: 176–181.
Stewart WC, Kolker AE, Sharpe ED, Day DG, Holmes KT, Leech JN et al. Factors associated with long-term progression or stability in primary open-angle glaucoma. Am J Ophthalmol 2000; 130: 274–279.
Konstas AGP, Hollo G, Astakhov YS, Teus MA, Akopov EL, Jenkins JN et al. Factors associated with long-term progression or stability in exfoliation glaucoma. Arch Ophthalmol 2004; 122: 29–33.
The AGIS Investigators. The advanced glaucoma intervention study (AGIS):7. The relationship between control of intraocular pressure and visual field deterioration. Am J Ophthalmol 2000; 130: 429–440.
Quigley HA, Maumenee AE . Long-term follow-up of treated open-angle glaucoma. Am J Ophthalmol 1979; 87: 519–525.
Kolker AE . Visual prognosis in advanced glaucoma: a comparison of medical and surgical therapy for retention of vision in 101 eyes with advanced glaucoma. Trans Am Ophthalmol Soc 1977; 75: 539.
Odberg T . Visual field prognosis in advanced glaucoma. Acta Ophthalmol 1987; 65: 27–29.
Schulzer M, Mikelberg FS, Drance SM . Some observations on the relation between intraocular pressure reduction and the progression of glaucomatous visual loss. Br J Ophthalmol 1987; 71: 486–488.
Grant WM, Burke JF . Why do some people go blind from glaucoma? Ophthalmology 1982; 89: 991–998.
Stewart WC, Sine CS, Lo Presto C . Surgical vs medical management of chronic open-angle glaucoma. Am J Ophthalmol 1996; 122: 767–774.
Mao LK, Stewart WC, Shields MB . Correlation between intraocular pressure control and progressive glaucomatous damage in primary open-angle glaucoma. Am J Ophthalmol 1991; 111: 51–55.
Herndon LW, Weizer JS, Stinnett SS . Central corneal thickness as a risk factor for advanced glaucoma damage. Arch Ophthalmol 2004; 122: 17–21.
Medeiros FA, Sample PA, Zangwill LM, Bowd C, Aihara M, Weinreb RN . Corneal thickness as a risk factor for visual field loss in patients with preperimetric glaucomatous optic neuropathy. Am J Ophthalmol 2003; 136: 805–813.
Stewart WC, Day DG, Jenkins JN, Passmore CL, Stewart JA . Mean intraocular pressure and progression based on corneal thickness in primary open-angle glaucoma. J Ocul Pharmacol Ther 2006; 22: 26–33.
Stewart WC, Jenkins JN, Stewart JA . Changes of intraocular pressure measurements and central corneal thickness following refractive surgery. Ophthalmology 2005; 112: 1637.
Hedman K, Watson PG, Alm A . The effect of latanoprost on intraocular pressure during 2 years of treatment. Surv Ophthalmol 2002; 47(Suppl 1): S65–S76.
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This study was not supported by any public or private funding agency.
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Konstas, A., Irkec, M., Teus, M. et al. Mean intraocular pressure and progression based on corneal thickness in patients with ocular hypertension. Eye 23, 73–78 (2009). https://doi.org/10.1038/sj.eye.6702995
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DOI: https://doi.org/10.1038/sj.eye.6702995
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