The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis

<p>Abstract</p> <p>Background</p> <p>Primary open-angle glaucoma (POAG) is one of the leading causes of blindness in the United States and worldwide. While lowering intraocular pressure (IOP) has been proven to be effective in delaying or preventing the onset of POAG in...

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Main Authors: Gao Feng, Miller J, Miglior Stefano, Beiser Julia A, Torri Valter, Kass Michael A, Gordon Mae O
Format: Article
Language:English
Published: BMC 2012-10-01
Series:BMC Medical Research Methodology
Subjects:
Online Access:http://www.biomedcentral.com/1471-2288/12/151
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author Gao Feng
Miller J
Miglior Stefano
Beiser Julia A
Torri Valter
Kass Michael A
Gordon Mae O
author_facet Gao Feng
Miller J
Miglior Stefano
Beiser Julia A
Torri Valter
Kass Michael A
Gordon Mae O
author_sort Gao Feng
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Primary open-angle glaucoma (POAG) is one of the leading causes of blindness in the United States and worldwide. While lowering intraocular pressure (IOP) has been proven to be effective in delaying or preventing the onset of POAG in many large-scale prospective studies, one of the recent hot topics in glaucoma research is the effect of IOP fluctuation (IOP lability) on the risk of developing POAG in treated and untreated subjects.</p> <p>Method</p> <p>In this paper, we analyzed data from the Ocular Hypertension Treatment Study (OHTS) and the European Glaucoma Prevention Study (EGPS) for subjects who had at least 2 IOP measurements after randomization prior to POAG diagnosis. We assessed the interrelationships among the baseline covariates, the changes of post-randomization IOP over time, and the risk of developing POAG, using a latent class analysis (LCA) which allows us to identify distinct patterns (latent classes) of IOP trajectories.</p> <p>Result</p> <p>The IOP change in OHTS was best described by 6 latent classes differentiated primarily by the mean IOP levels during follow-up. Subjects with high post-randomization mean IOP level and/or large variability were more likely to develop POAG. Five baseline factors were found to be significantly predictive of the IOP classification in OHTS: treatment assignment, baseline IOP, gender, race, and history of hypertension. In separate analyses of EGPS, LCA identified different patterns of IOP change from those in OHTS, but confirmed that subjects with high mean level and large variability were at high risk to develop POAG.</p> <p>Conclusion</p> <p>LCA provides a useful tool to assess the impact of post-randomization IOP level and fluctuation on the risk of developing POAG in patients with ocular hypertension. The incorporation of post-randomization IOP can improve the overall predictive ability of the original model that included only baseline risk factors.</p>
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spelling doaj.art-4cf4d7e272f344a3a7e36c78a3a3833d2022-12-21T22:01:17ZengBMCBMC Medical Research Methodology1471-22882012-10-0112115110.1186/1471-2288-12-151The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysisGao FengMiller JMiglior StefanoBeiser Julia ATorri ValterKass Michael AGordon Mae O<p>Abstract</p> <p>Background</p> <p>Primary open-angle glaucoma (POAG) is one of the leading causes of blindness in the United States and worldwide. While lowering intraocular pressure (IOP) has been proven to be effective in delaying or preventing the onset of POAG in many large-scale prospective studies, one of the recent hot topics in glaucoma research is the effect of IOP fluctuation (IOP lability) on the risk of developing POAG in treated and untreated subjects.</p> <p>Method</p> <p>In this paper, we analyzed data from the Ocular Hypertension Treatment Study (OHTS) and the European Glaucoma Prevention Study (EGPS) for subjects who had at least 2 IOP measurements after randomization prior to POAG diagnosis. We assessed the interrelationships among the baseline covariates, the changes of post-randomization IOP over time, and the risk of developing POAG, using a latent class analysis (LCA) which allows us to identify distinct patterns (latent classes) of IOP trajectories.</p> <p>Result</p> <p>The IOP change in OHTS was best described by 6 latent classes differentiated primarily by the mean IOP levels during follow-up. Subjects with high post-randomization mean IOP level and/or large variability were more likely to develop POAG. Five baseline factors were found to be significantly predictive of the IOP classification in OHTS: treatment assignment, baseline IOP, gender, race, and history of hypertension. In separate analyses of EGPS, LCA identified different patterns of IOP change from those in OHTS, but confirmed that subjects with high mean level and large variability were at high risk to develop POAG.</p> <p>Conclusion</p> <p>LCA provides a useful tool to assess the impact of post-randomization IOP level and fluctuation on the risk of developing POAG in patients with ocular hypertension. The incorporation of post-randomization IOP can improve the overall predictive ability of the original model that included only baseline risk factors.</p>http://www.biomedcentral.com/1471-2288/12/151Latent class analysisLongitudinal dataTime-dependent covariatePrediction modelSurvival dataPrimary open-angle glaucomaIntraocular pressure fluctuation
spellingShingle Gao Feng
Miller J
Miglior Stefano
Beiser Julia A
Torri Valter
Kass Michael A
Gordon Mae O
The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis
BMC Medical Research Methodology
Latent class analysis
Longitudinal data
Time-dependent covariate
Prediction model
Survival data
Primary open-angle glaucoma
Intraocular pressure fluctuation
title The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis
title_full The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis
title_fullStr The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis
title_full_unstemmed The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis
title_short The effect of changes in intraocular pressure on the risk of primary open-angle glaucoma in patients with ocular hypertension: an application of latent class analysis
title_sort effect of changes in intraocular pressure on the risk of primary open angle glaucoma in patients with ocular hypertension an application of latent class analysis
topic Latent class analysis
Longitudinal data
Time-dependent covariate
Prediction model
Survival data
Primary open-angle glaucoma
Intraocular pressure fluctuation
url http://www.biomedcentral.com/1471-2288/12/151
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