Literature DB >> 22027930

The value of intraocular pressure asymmetry in diagnosing glaucoma.

Alice L Williams1, Srinivas Gatla, Benjamin E Leiby, Iman Fahmy, Amitava Biswas, Daniela M de Barros, Rengappa Ramakrishnan, Suruchi Bhardwaj, Carrie Wright, Suneeta Dubey, Jorge F Lynch, Atilla Bayer, Rekha Khandelwal, Parul Ichhpujani, Moataz Gheith, Ghada Siam, Robert M Feldman, Jeffrey D Henderer, George L Spaeth.   

Abstract

PURPOSE: To investigate the amount of intraocular pressure (IOP) asymmetry in a large group of ethnically diverse patients with and without glaucoma, and to delineate the risk for glaucoma which increasing amounts of IOP asymmetry confer upon the patient. PATIENTS AND METHODS: Collaborative retrospective study of 326 glaucoma patients and 326 controls. Former Wills Eye Institute fellows collected single pre-treatment measurements of IOP on patients diagnosed as having definite glaucoma based on characteristic optic nerve damage and confirmatory visual field damage. Patients with a normal eye examination who had normal-appearing optic discs and no apparent glaucoma, or who had a normal eye examination in association with refractive error or cataract, were used as controls.
RESULTS: Intraocular pressure asymmetry is a significant risk factor for having glaucoma (odds ratio, 2.14; 95% confidence interval, 1.86-2.47; P<0.001). Absence of IOP asymmetry between the fellow eyes is associated with a 1% probability of having glaucoma. A difference of 3 mm Hg is associated with a 6% probability of having glaucoma, and a difference of >6 mm Hg with a 57% probability of having glaucoma. The association between IOP asymmetry and glaucoma status is significant for subjects with both elevated IOP (P=0.014) and statistically normal IOP (maximum IOP ≤ 21 mm Hg; P<0.001).
CONCLUSIONS: Inter-eye asymmetry of IOP is a common finding in patients with glaucoma. There is a direct relationship between the amount of IOP asymmetry between the fellow eyes and the likelihood of having glaucoma.

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Year:  2013        PMID: 22027930     DOI: 10.1097/IJG.0b013e318237bfb8

Source DB:  PubMed          Journal:  J Glaucoma        ISSN: 1057-0829            Impact factor:   2.503


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