Bo Ram Seol1,2, Soa Kim3, Dong Myung Kim1,2, Ki Ho Park1,2, Jin Wook Jeoung1,2, Seok Hwan Kim4,5. 1. Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. 2. Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea. 3. Department of Ophthalmology, Gyeonggi Province Medical Center Suwon Hospital, Suwon, Gyeonggi Province, Korea. 4. Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. xcski@hanmail.net. 5. Department of Ophthalmology, Seoul National University Boramae Hospital, #425 Shindaebang-dong, Dongjak-gu, Seoul, 156-707, Korea. xcski@hanmail.net.
Abstract
Purpose To evaluate the influence of intraocular pressure (IOP) reduction on progression of normal-tension glaucoma (NTG) with myopic tilted disc and to demonstrate the associated risk factors. METHODS: The medical records on 109 eyes of 109 NTG patients with myopic tilted discs who were followed up for more than 5 years and treated with topical medications were reviewed. Glaucoma progression was defined according to either structural or functional deterioration. Patients were divided into tertile groups according to the percent IOP reduction from the baseline, and the cumulative probability of NTG nonprogression of the upper- and lower-tertile groups was compared using Kaplan-Meier survival analysis. The multivariate Cox proportional hazards model was used to identify the risk factors for glaucoma progression. RESULTS: Forty-nine of 109 eyes (45.0%) showed glaucoma progression after the average follow-up period of 7.55 ± 1.79 years. The Kaplan-Meier analysis revealed a greater cumulative probability of nonprogression for the upper-tertile group (percent IOP reduction >20.9%) than for the lower-tertile group (percent IOP reduction<12.9%; P = 0.016). The Cox proportional hazards model indicated that presence of disc hemorrhage was a factor associated with glaucoma progression (HR = 3.664; P = 0.001). CONCLUSIONS: Lower-percent reduction in IOP was associated with NTG progression in eyes with myopic tilted discs, and the presence of disc hemorrhage was a risk factor for NTG progression.
Purpose To evaluate the influence of intraocular pressure (IOP) reduction on progression of normal-tension glaucoma (NTG) with myopic tilted disc and to demonstrate the associated risk factors. METHODS: The medical records on 109 eyes of 109 NTG patients with myopic tilted discs who were followed up for more than 5 years and treated with topical medications were reviewed. Glaucoma progression was defined according to either structural or functional deterioration. Patients were divided into tertile groups according to the percent IOP reduction from the baseline, and the cumulative probability of NTG nonprogression of the upper- and lower-tertile groups was compared using Kaplan-Meier survival analysis. The multivariate Cox proportional hazards model was used to identify the risk factors for glaucoma progression. RESULTS: Forty-nine of 109 eyes (45.0%) showed glaucoma progression after the average follow-up period of 7.55 ± 1.79 years. The Kaplan-Meier analysis revealed a greater cumulative probability of nonprogression for the upper-tertile group (percent IOP reduction >20.9%) than for the lower-tertile group (percent IOP reduction<12.9%; P = 0.016). The Cox proportional hazards model indicated that presence of disc hemorrhage was a factor associated with glaucoma progression (HR = 3.664; P = 0.001). CONCLUSIONS: Lower-percent reduction in IOP was associated with NTG progression in eyes with myopic tilted discs, and the presence of disc hemorrhage was a risk factor for NTG progression.
Authors: Eugene Tay; Steve K Seah; Siew-Pang Chan; Albert T H Lim; Sek-Jin Chew; Paul J Foster; Tin Aung Journal: Am J Ophthalmol Date: 2005-02 Impact factor: 5.258
Authors: Joseph L Demer; Robert A Clark; Soh Youn Suh; Joann A Giaconi; Kouros Nouri-Mahdavi; Simon K Law; Laura Bonelli; Anne L Coleman; Joseph Caprioli Journal: Curr Eye Res Date: 2019-12-02 Impact factor: 2.424