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Abstract #6423 Published in IGR 3-2
Clinical factors associated with progression of glaucomatous optic disc damage in treated patients
Tezel G; Siegmund KD; Trinkaus K; Wax MB; Kass MA; Kolker AEArchives of Ophthalmology 2001; 119: 813-818
BACKGROUND: Reducing intraocular pressure (IOP) in glaucomatous eyes does not always prevent disease progression. OBJECTIVE: To determine the clinical factors associated with progressive optic disc damage in glaucomatous eyes receiving treatment to reduce IOP. METHODS: Baseline and follow-up optic disc photographs as well as demographic and clinical data were retrospectively studied in 186 eyes of 93 patients with primary open-angle glaucoma (POAG), and in 138 eyes of 69 patients with normal-pressure glaucoma (NPG). The patients with POAG were included in the study only if their treated IOPs during a follow-up period of five years were less than 21 mmHg. The patients with NPG were included only if their IOPs were reduced by at least 20% during the follow-up period. The association of progressive optic disc damage with patient- and eye-specific characteristics was examined using multivariate analysis. RESULTS: During the five-year study period, 141 (43.5%) of the 324 eyes exhibited progressive optic disc damage defined by at least a 5% decrease in the neural rim area-to-disc area ratio. Using multivariate analysis, the following were found to be strongly associated with progressive neural rim damage: a baseline smaller neural rim area-disc area ratio (p < 0.001); a baseline larger zone β area-disc area ratio (p = 0.04); a baseline larger parapapillary atrophy length-disc circumference ratio (p = 0.05); a diagnosis of NPG (p = 0.01); and combined medical and surgical treatment prior to the study period (p = 0.01). CONCLUSIONS: Clinical factors other than IOP may be important indicators of subsequent progression of glaucomatous optic disc damage. These findings suggest that eyes with advanced glaucomatous optic disc damage and NPT are more likely to progress, despite receiving treatment to reduce IOP.
Dr G. Tezel, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, MO, USA
Classification:
9.2.2 Other risk factors for glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
9.2.3 Open angle glaucoma with elevated IOP (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
9.2.4 Normal pressure glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)