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Abstract #28032 Published in IGR 13-1
Factors associated with topographic changes of the optic nerve head induced by acute intraocular pressure reduction in glaucoma patients
Prata TS; Lima VC; De Moraes CGV; Guedes LM; Magalhes FP; Teixeira SH; Ritch R; Paranhos Jr AEye 2011; 25: 201-207
PurposeTo investigate factors associated with changes in optic nerve head (ONH) topography after acute intraocular pressure (IOP) reduction in patients with primary open-angle glaucoma (POAG).MethodsUntreated POAG patients (IOP >21 mm Hg) were prospectively enrolled. Systemic and ocular information were collected, including central corneal thickness (CCT) and corneal hysteresis (CH). All patients underwent confocal scanning laser ophthalmoscopy and tonometry (Goldmann) before and 1 h after pharmacological IOP reduction. The mean of three measurements was considered for analysis. Changes in each ONH topographic parameter were assessed (one eye was randomly selected), and those that changed significantly were correlated with patient's systemic and ocular characteristics.ResultsA total of 42 patients were included (mean age, 66.7(plus or minus)11.8 years). After a mean IOP reduction of 47.3(plus or minus)11.9%, significant changes were observed in cup area and volume, and in rim area and volume (P<0.01), but not in mean cup depth (P=0.80). Multiple regression analysis (controlling for baseline IOP and magnitude of IOP reduction) showed that CH (r(2)=0.17, P<0.01) and diabetes diagnosis (r (2)(greater-than or equal to)0.21, P<0.01) were negatively correlated with the magnitude of changes in ONH parameters, whereas the cup-to-disc ratio was positively correlated (r(2)=0.30, P<0.01). Age, race, disc area, and CCT were not significant (P(greater-than or equal to)0.12). Including all significant factors in a multivariable model, only the presence of diabetes remained significantly associated with all ONH parameters evaluated (P<0.01). Conclusions Different systemic and ocular factors, such as diabetes, CH, and the relative size of the cup, seem to be associated with the magnitude of changes in ONH topography after acute IOP reduction in POAG patients. These associations partially explain the ONH changes observed in these patients and suggest that other factors are possibly implicated in an individual susceptibility to IOP
T. S. Prata. Department of Ophthalmology, Federal University of Sao Paulo, Rua Botucatu, Sao Paulo 820, Brazil. tiagoprata@ig.com.br
Classification:
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
9.2.2 Other risk factors for glaucoma (Part of: 9 Clinical forms of glaucomas > 9.2 Primary open angle glaucomas)
