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Peak Intraocular Pressure Tied to Glaucoma Progression

Visual field progression in treated glaucoma affected by intraocular and other risk factors

TUESDAY, May 10 (HealthDay News) -- Visual field (VF) progression in treated glaucoma is affected by intraocular pressure (IOP)-dependent and IOP-independent risk factors, according to a study published in the May issue of the Archives of Ophthalmology.

Carlos Gustavo V. De Moraes, M.D., from the New York Eye and Ear Infirmary in New York City, and colleagues examined the IOP-dependent and IOP-independent variables linked to VF progression in treated glaucoma. Data was collected from 587 glaucoma patients (average age, 64.9 years) with repeatable VF loss, who had eight or more VF examinations of either eye between 1999 and 2009. Data including age, gender, race, central corneal thickness, baseline VF mean deviation, mean follow-up IOP, peak IOP, IOP fluctuation, a detected disc hemorrhage, and presence of beta-zone parapapillary atrophy were analyzed.

The investigators found that, based on the univariable model, a higher risk of VF progression was correlated with older age (odds ratio [OR], 1.19 per decade), baseline diagnosis of exfoliation syndrome (OR, 1.79), decreased central corneal thickness (OR, 1.38 per 40 µm thinner), a detected disc hemorrhage (OR, 2.31), presence of beta-zone parapapillary atrophy (OR, 2.17), and all IOP parameters. In the multivariable model, VF progression peak was correlated with peak IOP (OR, 1.13), thinner central corneal thickness (OR, 1.45 per 40 µm thinner), a detected disc hemorrhage (OR, 2.59), and presence of beta-zone parapapillary atrophy (OR, 2.38).

"IOP-dependent and IOP-independent risk factors affect disease progression in treated glaucoma. Peak IOP is a better predictor of progression than is IOP mean or fluctuation," the authors write.

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