Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression
Juliane Matlach,1 Sandra Bender,2 Jochem König,2 Harald Binder,2,3 Norbert Pfeiffer,1 Esther M Hoffmann1 1Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany; 2Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz,...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-12-01
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| Series: | Clinical Ophthalmology |
| Subjects: | |
| Online Access: | https://www.dovepress.com/investigation-of-intraocular-pressure-fluctuation-as-a-risk-factor-of--peer-reviewed-article-OPTH |
| _version_ | 1818427941276614656 |
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| author | Matlach J Bender S König J Binder H Pfeiffer N Hoffmann EM |
| author_facet | Matlach J Bender S König J Binder H Pfeiffer N Hoffmann EM |
| author_sort | Matlach J |
| collection | DOAJ |
| description | Juliane Matlach,1 Sandra Bender,2 Jochem König,2 Harald Binder,2,3 Norbert Pfeiffer,1 Esther M Hoffmann1 1Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany; 2Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany; 3Institute of Medical Biometry and Statistics, Medical Center – University of Freiburg, Freiburg, Germany Purpose: Since the role of short- and long-term intraocular pressure (IOP) fluctuation as a predictor of glaucoma progression is still controversial, the purpose of this study was to investigate the role of IOP fluctuation in a non-selected patient cohort. Materials and methods: Two-hundred and forty eyes of 120 glaucoma patients (51% female) with a mean age of 64.5 years were included. Inclusion criteria were at least a visual field (VF) and a 48-hour diurnal phasing of IOP including nocturnal measurement. Glaucoma progression was defined as – if available – confirmed progression of reproducible VF defects in at least three VF examinations or increase of cup area on optic nerve imaging (Heidelberg Retina Tomograph [HRT]) with at least two images after baseline. If results were stable or less than previously mentioned VF or HRT examinations were available, it was classified as “no progression”. Results: Glaucoma progression was seen in seven of 240 eyes in the VF analysis and ten of 240 eyes on HRT. Of all 240 eyes, 92 and 41 eyes fulfilled the criteria to be included for progression evaluation on VF and HRT analysis, respectively. Mean time to progression ± standard error was 3.6±0.2 years on VF and 4.5±0.3 years on HRT. Univariate and multivariate Cox regression analyses revealed short-term IOP fluctuation (P<0.0001) and maximum IOP (P<0.001) as risk factors for glaucoma progression on VF. There was no significant influence of demographic characteristics, ocular or general health on glaucoma progression. Conclusion: Short-term IOP fluctuation was associated with the progression of glaucoma in this non-selected cohort of glaucoma patients receiving phasing of IOP. Keywords: glaucoma progression, short-term IOP fluctuation, long-term IOP fluctuation, glaucoma imaging, visual field |
| first_indexed | 2024-12-14T14:53:43Z |
| format | Article |
| id | doaj.art-f4dbf1e577344958afdf304b91013e8c |
| institution | Directory Open Access Journal |
| issn | 1177-5483 |
| language | English |
| last_indexed | 2024-12-14T14:53:43Z |
| publishDate | 2018-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-f4dbf1e577344958afdf304b91013e8c2022-12-21T22:57:04ZengDove Medical PressClinical Ophthalmology1177-54832018-12-01Volume 1391643118Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progressionMatlach JBender SKönig JBinder HPfeiffer NHoffmann EMJuliane Matlach,1 Sandra Bender,2 Jochem König,2 Harald Binder,2,3 Norbert Pfeiffer,1 Esther M Hoffmann1 1Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany; 2Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center Mainz, Mainz, Germany; 3Institute of Medical Biometry and Statistics, Medical Center – University of Freiburg, Freiburg, Germany Purpose: Since the role of short- and long-term intraocular pressure (IOP) fluctuation as a predictor of glaucoma progression is still controversial, the purpose of this study was to investigate the role of IOP fluctuation in a non-selected patient cohort. Materials and methods: Two-hundred and forty eyes of 120 glaucoma patients (51% female) with a mean age of 64.5 years were included. Inclusion criteria were at least a visual field (VF) and a 48-hour diurnal phasing of IOP including nocturnal measurement. Glaucoma progression was defined as – if available – confirmed progression of reproducible VF defects in at least three VF examinations or increase of cup area on optic nerve imaging (Heidelberg Retina Tomograph [HRT]) with at least two images after baseline. If results were stable or less than previously mentioned VF or HRT examinations were available, it was classified as “no progression”. Results: Glaucoma progression was seen in seven of 240 eyes in the VF analysis and ten of 240 eyes on HRT. Of all 240 eyes, 92 and 41 eyes fulfilled the criteria to be included for progression evaluation on VF and HRT analysis, respectively. Mean time to progression ± standard error was 3.6±0.2 years on VF and 4.5±0.3 years on HRT. Univariate and multivariate Cox regression analyses revealed short-term IOP fluctuation (P<0.0001) and maximum IOP (P<0.001) as risk factors for glaucoma progression on VF. There was no significant influence of demographic characteristics, ocular or general health on glaucoma progression. Conclusion: Short-term IOP fluctuation was associated with the progression of glaucoma in this non-selected cohort of glaucoma patients receiving phasing of IOP. Keywords: glaucoma progression, short-term IOP fluctuation, long-term IOP fluctuation, glaucoma imaging, visual fieldhttps://www.dovepress.com/investigation-of-intraocular-pressure-fluctuation-as-a-risk-factor-of--peer-reviewed-article-OPTHGlaucoma progressionshort-term IOP fluctuationlong-term IOP fluctuationglaucoma imagingvisual field |
| spellingShingle | Matlach J Bender S König J Binder H Pfeiffer N Hoffmann EM Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression Clinical Ophthalmology Glaucoma progression short-term IOP fluctuation long-term IOP fluctuation glaucoma imaging visual field |
| title | Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression |
| title_full | Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression |
| title_fullStr | Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression |
| title_full_unstemmed | Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression |
| title_short | Investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression |
| title_sort | investigation of intraocular pressure fluctuation as a risk factor of glaucoma progression |
| topic | Glaucoma progression short-term IOP fluctuation long-term IOP fluctuation glaucoma imaging visual field |
| url | https://www.dovepress.com/investigation-of-intraocular-pressure-fluctuation-as-a-risk-factor-of--peer-reviewed-article-OPTH |
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