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Abstract #9194 Published in IGR 5-2
Intraocular pressure and visual field loss in primary angle closure and primary open angle glaucomas
Gazzard G; Foster PJ; Devereux JG; Oen F; Chew P; Khaw PT; Seah SBritish Journal of Ophthalmology 2003; 87: 720-725
AIM: To compare the correlation between visual field loss and the pretreatment intraocular pressure (IOP) in primary angle-closure glaucoma (PACG) and primary open-angle glaucoma (POAG). METHODS: In a cross-sectional observational study of 74 patients (43 PACG, 31 POAG), pretreatment IOP was measured at presentation, before treatment was initiated. The severity of visual field loss was assessed by AGIS score, mean deviation (MD), pattern standard deviation (PSD), and corrected pattern standard deviation (CPSD). Glaucomatous optic neuropathy was assessed from simultaneous stereo disc photographs. RESULTS: There was a stronger correlation between pretreatment IOP and the extent of visual field loss in PACG subjects than in those with POAG for both MD (PACG: Pearson correlation coefficient (r) = 0.43, p = 0.002; r2 = 0.19), (POAG: r = 0.21, p = 0.13; r2 = 0.04) and AGIS score (PACG: r = 0.41, p = 0.003; r2 = 0.17), (POAG: r = 0.23, p = 0.19; r2 = 0.05, respectively). No such associations were seen for pattern standard deviation (PSD) or corrected pattern standard deviation (CPSD) in either group (p > 0.29). Both horizontal and vertical cup-disc ratio were well correlated with severity of field loss but not with presenting IOP for either diagnosis. CONCLUSIONS: This is consistent with the hypothesis of a greater IOP dependence for optic nerve damage in PACG than POAG and, conversely, a greater importance of other, less pressure dependent mechanisms in POAG compared to PACG.
Dr. G. Gazzard, Singapore National Eye Centre, (SNEC), 11 Third Hospital Avenue, Singapore 168751, Republic of Singapore. gus@gazzard.demmon.co.uk
Classification:
6.6.2 Automated (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
9.2.3 Open angle glaucoma with elevated IOP (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
9.3.2 Chronic primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
