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Abstract #54602 Published in IGR 15-3
Relationship between 24-hour mean ocular perfusion pressure fluctuation and rate of paracentral visual field progression in normal-tension glaucoma
Choi J; Lee JR; Lee Y; Lee KS; Na JH; Han S; Kook MSInvestigative Ophthalmology and Visual Science 2013; 54: 6150-6157
PURPOSE: To investigate the relationship between unstable mean ocular perfusion pressure (MOPP) and the rate of paracentral visual field (PVF) progression in patients with medically treated normal-tension glaucoma (NTG). METHODS: The data of 157 eyes of 122 patients with NTG who were followed for more than 6 years (mean follow-up, 8.7 years ± 12.6 months) and had more than 5 reliable standard visual field (VF) tests were analyzed retrospectively. Groups in the highest, middle, and lowest tertiles of 24-hour MOPP fluctuation (HMF, MMF, and LMF, respectively) were compared in terms of rates of change of mean thresholds in the central 10° (PVF), 10° to 24°, and global areas by using a linear mixed model. Clinical factors associated with rapid PVF progression were also investigated. RESULTS: The LMF and HMF groups did not differ significantly in the mean global rate of VF changes (-0.52 vs. -0.71 dB/y; P = 0.07). The HMF group had a significantly faster progression of VF defects in the central 10° area than the LMF group (-1.02 vs. -0.54 dB/y; P < 0.001) but did not differ in terms of progression of VF defects in the peripheral 10° to 24° area (-0.39 vs. -0.495 dB/y; P = 0.425). PVF progression was significantly associated with 24-hour MOPP fluctuation (β = -0.31, P < 0.001) and VF damage severity at initial presentation (β = 0.134, P = 0.011). CONCLUSIONS: Medically treated NTG eyes with greater 24-hour MOPP fluctuations (HMF) had faster PVF defect progression than eyes with stable 24-hour MOPP (LMF). Twenty-four hour MOPP fluctuation associated significantly with PVF progression velocity.
Seoul Central Eye Hospital, Seoul, Republic of Korea.
Full articleClassification:
6.1.2 Fluctuation, circadian rhythms (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
6.20 Progression (Part of: 6 Clinical examination methods)
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
