Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study
Objective: To assess the relationship between baseline intraocular pressure (IOP), blood pressure (BP) and ocular perfusion pressure (OPP), and the 5-year visual field progression in normal-tension glaucoma (NTG) patients. Design: Prospective, longitudinal study. Methods: Sixty-five NTG patients who...
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Springer Nature
2018
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| author | Raman, Pushpa Suliman, Nurull Bahya Zahari, Mimiwati Kook, Michael Scott Ramli, Norlina Mohd |
| author_facet | Raman, Pushpa Suliman, Nurull Bahya Zahari, Mimiwati Kook, Michael Scott Ramli, Norlina Mohd |
| author_sort | Raman, Pushpa |
| collection | UM |
| description | Objective: To assess the relationship between baseline intraocular pressure (IOP), blood pressure (BP) and ocular perfusion pressure (OPP), and the 5-year visual field progression in normal-tension glaucoma (NTG) patients. Design: Prospective, longitudinal study. Methods: Sixty-five NTG patients who were followed up for 5 years are included in this study. All the enrolled patients underwent baseline 24-h IOP and BP monitoring via 2-hourly measurements in their habitual position and were followed up for over 5 years with reliable VF tests. Modified Anderson criteria were used to assess VF progression. Univariable and multivariable analyses using Cox's proportional hazards model were used to identify the systemic and clinical risk factors that predict progression. Kaplan-Meier survival analyses were used to compare the time elapsed to confirmed VF progression in the presence or absence of each potential risk factor. Results: At 5-year follow-up, 35.4% of the enrolled patients demonstrated visual field progression. There were statistically significant differences in the mean diastolic blood pressure (p < 0.05) and diastolic OPP (p < 0.05) between the progressing and the non-progressing group. There was no association between IOP parameters and NTG progression. Multivariable analysis identified low nocturnal DOPP at baseline as a significant predictive risk factor for glaucomatous visual field progression at 5 years. An mmHg decrease in nocturnal DOPP increases the hazard of progression by 1.4 times. Patients with DOPP < 35 mmHg have 2.3-fold higher probability of progressing compared to the patients with DOPP > 43.7 mmHg (log rank = 0.018). Conclusion: Diastolic parameters of BP and OPP were significantly lower in the NTG patients who progressed after 5 years. Low nocturnal DOPP is an independent predictor of glaucomatous visual field progression in NTG patients. |
| first_indexed | 2024-03-06T05:52:43Z |
| format | Article |
| id | um.eprints-20934 |
| institution | Universiti Malaya |
| last_indexed | 2024-03-06T05:52:43Z |
| publishDate | 2018 |
| publisher | Springer Nature |
| record_format | dspace |
| spelling | um.eprints-209342019-04-16T08:09:42Z http://eprints.um.edu.my/20934/ Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study Raman, Pushpa Suliman, Nurull Bahya Zahari, Mimiwati Kook, Michael Scott Ramli, Norlina Mohd R Medicine Objective: To assess the relationship between baseline intraocular pressure (IOP), blood pressure (BP) and ocular perfusion pressure (OPP), and the 5-year visual field progression in normal-tension glaucoma (NTG) patients. Design: Prospective, longitudinal study. Methods: Sixty-five NTG patients who were followed up for 5 years are included in this study. All the enrolled patients underwent baseline 24-h IOP and BP monitoring via 2-hourly measurements in their habitual position and were followed up for over 5 years with reliable VF tests. Modified Anderson criteria were used to assess VF progression. Univariable and multivariable analyses using Cox's proportional hazards model were used to identify the systemic and clinical risk factors that predict progression. Kaplan-Meier survival analyses were used to compare the time elapsed to confirmed VF progression in the presence or absence of each potential risk factor. Results: At 5-year follow-up, 35.4% of the enrolled patients demonstrated visual field progression. There were statistically significant differences in the mean diastolic blood pressure (p < 0.05) and diastolic OPP (p < 0.05) between the progressing and the non-progressing group. There was no association between IOP parameters and NTG progression. Multivariable analysis identified low nocturnal DOPP at baseline as a significant predictive risk factor for glaucomatous visual field progression at 5 years. An mmHg decrease in nocturnal DOPP increases the hazard of progression by 1.4 times. Patients with DOPP < 35 mmHg have 2.3-fold higher probability of progressing compared to the patients with DOPP > 43.7 mmHg (log rank = 0.018). Conclusion: Diastolic parameters of BP and OPP were significantly lower in the NTG patients who progressed after 5 years. Low nocturnal DOPP is an independent predictor of glaucomatous visual field progression in NTG patients. Springer Nature 2018 Article PeerReviewed Raman, Pushpa and Suliman, Nurull Bahya and Zahari, Mimiwati and Kook, Michael Scott and Ramli, Norlina Mohd (2018) Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study. Eye, 32 (7). pp. 1183-1189. ISSN 0950-222X, DOI https://doi.org/10.1038/s41433-018-0057-8 <https://doi.org/10.1038/s41433-018-0057-8>. https://doi.org/10.1038/s41433-018-0057-8 doi:10.1038/s41433-018-0057-8 |
| spellingShingle | R Medicine Raman, Pushpa Suliman, Nurull Bahya Zahari, Mimiwati Kook, Michael Scott Ramli, Norlina Mohd Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study |
| title | Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study |
| title_full | Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study |
| title_fullStr | Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study |
| title_full_unstemmed | Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study |
| title_short | Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study |
| title_sort | low nocturnal diastolic ocular perfusion pressure as a risk factor for ntg progression a 5 year prospective study |
| topic | R Medicine |
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